Provider Demographics
NPI:1851913974
Name:EBENEZER HEALTH INVESTORS INC
Entity Type:Organization
Organization Name:EBENEZER HEALTH INVESTORS INC
Other - Org Name:TRUE PHARMACY ON DEVINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-849-1500
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:SC
Mailing Address - Zip Code:29053-0310
Mailing Address - Country:US
Mailing Address - Phone:803-849-1500
Mailing Address - Fax:803-849-1510
Practice Address - Street 1:3217 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1847
Practice Address - Country:US
Practice Address - Phone:803-849-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy