Provider Demographics
NPI:1356516991
Name:PARKER ROAD DRUGS
Entity type:Organization
Organization Name:PARKER ROAD DRUGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:LUANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-242-1101
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:864-476-9040
Mailing Address - Fax:864-476-9042
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:864-476-9040
Practice Address - Fax:864-476-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDME 458Medicaid