Organization Name: | BANKS PHARMACY |
NPI Number: | 1114108735 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEITH JAMES MATTHEWS (PHARMACIST-IN-CHARGE) |
Mailing Address: | 100 Ridge Medical Plaza Suite 101 Edgefield |
State: | SC US |
Postal Code: | 29824 |
Phone Number: | 8036375757 |
Fax Number: | 8036379996 |
NPI Enumeration Date: | 11/26/2007 |
NPI Last Update Date: | 02/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |