Provider Demographics
NPI:1669626172
Name:PARKER ROAD DRUGS, INC.
Entity Type:Organization
Organization Name:PARKER ROAD DRUGS, INC.
Other - Org Name:PARKER MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-346-3614
Mailing Address - Street 1:339 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:SC
Mailing Address - Zip Code:29388-1831
Mailing Address - Country:US
Mailing Address - Phone:864-476-2126
Mailing Address - Fax:
Practice Address - Street 1:339 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388-1831
Practice Address - Country:US
Practice Address - Phone:864-476-2126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKER ROAD DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0451820001Medicare NSC