Provider Demographics
NPI:1497446256
Name:LORIS DRUG COMPANY LLC
Entity Type:Organization
Organization Name:LORIS DRUG COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:803-463-1401
Mailing Address - Street 1:4125 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LORIS
Mailing Address - State:SC
Mailing Address - Zip Code:29569-3023
Mailing Address - Country:US
Mailing Address - Phone:843-756-4021
Mailing Address - Fax:843-756-9124
Practice Address - Street 1:4125 MAIN ST
Practice Address - Street 2:
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-3023
Practice Address - Country:US
Practice Address - Phone:843-756-4021
Practice Address - Fax:843-756-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy