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Contact Information

VINCENTS DRUG STORE AND SODA FOUNTAIN
110 PLANTED ROW LANE
JOHNS ISLAND, SC29455
 Phone: 843-243-0007
 Fax: 843-243-0039
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for VINCENTS DRUG STORE AND SODA FOUNTAIN

NPI Number 1265515795
LBN Legal business name VINCENTS DRUG STORE AND SODA FOUNTAIN
Authorized official SUSAN CAIN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/20/2006
Last updated 02/21/2017 - About 9 years ago
Identifiers
SC License # 9712
SC Medicaid 782460
Other 2092739 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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