Provider Demographics
NPI:1801267331
Name:DISCOUNT PHARMACY OF DILLON LLC
Entity type:Organization
Organization Name:DISCOUNT PHARMACY OF DILLON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DRUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:843-356-0172
Mailing Address - Street 1:1115B US 301 NORTH
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536
Mailing Address - Country:US
Mailing Address - Phone:843-356-0172
Mailing Address - Fax:843-383-8855
Practice Address - Street 1:1115 HIGHWAY 301 N STE B
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2498
Practice Address - Country:US
Practice Address - Phone:843-356-0172
Practice Address - Fax:843-383-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherEIN