Provider Demographics
NPI:1518626126
Name:GREER PHARMACY LLC
Entity Type:Organization
Organization Name:GREER PHARMACY LLC
Other - Org Name:VISTARA GREER DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DESERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-473-5700
Mailing Address - Street 1:6140D WADE HAMPTON BLVD
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-5350
Mailing Address - Country:US
Mailing Address - Phone:864-473-5700
Mailing Address - Fax:864-473-5701
Practice Address - Street 1:6140D WADE HAMPTON BLVD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5350
Practice Address - Country:US
Practice Address - Phone:864-473-5700
Practice Address - Fax:864-473-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy