Provider Demographics
NPI:1205146875
Name:LAURENS DRUG COMPANY ,LLC
Entity type:Organization
Organization Name:LAURENS DRUG COMPANY ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:YOUMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-681-4663
Mailing Address - Street 1:923 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2605
Mailing Address - Country:US
Mailing Address - Phone:864-681-4663
Mailing Address - Fax:866-611-3654
Practice Address - Street 1:923 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2605
Practice Address - Country:US
Practice Address - Phone:864-681-4663
Practice Address - Fax:866-611-3654
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAURENS DRUG COMPANY ,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-18
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy