Provider Demographics
NPI:1881088805
Name:DOTTIES PHARMACY LLC
Entity type:Organization
Organization Name:DOTTIES PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WACLAWEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-876-2323
Mailing Address - Street 1:325 FOLLY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2507
Mailing Address - Country:US
Mailing Address - Phone:843-501-9500
Mailing Address - Fax:
Practice Address - Street 1:325 FOLLY RD STE 305
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2597
Practice Address - Country:US
Practice Address - Phone:843-501-9500
Practice Address - Fax:843-414-7453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC156993336S0011X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy