Provider Demographics
NPI:1417084252
Name:GREENVILLE DRUG CO., INC
Entity Type:Organization
Organization Name:GREENVILLE DRUG CO., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TIGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-672-4221
Mailing Address - Street 1:P.O. BOX 69
Mailing Address - Street 2:121 SOUTH COURT SQUARE
Mailing Address - City:GREENVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30222
Mailing Address - Country:US
Mailing Address - Phone:706-672-4221
Mailing Address - Fax:706-672-0586
Practice Address - Street 1:121 SOUTH COURT SQUARE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:GA
Practice Address - Zip Code:30222
Practice Address - Country:US
Practice Address - Phone:706-672-4221
Practice Address - Fax:706-672-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy