Provider Demographics
NPI:1891850210
Name:B AND B CORPORATION
Entity Type:Organization
Organization Name:B AND B CORPORATION
Other - Org Name:SPRINGDALE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNTS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-796-4070
Mailing Address - Street 1:3315 PLATT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-2203
Mailing Address - Country:US
Mailing Address - Phone:803-796-4070
Mailing Address - Fax:803-796-7022
Practice Address - Street 1:3315 PLATT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-2203
Practice Address - Country:US
Practice Address - Phone:803-796-4070
Practice Address - Fax:803-796-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC500010943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC607519Medicaid
4207090OtherNCPDP PROVIDER IDENTIFICATION NUMBER