Provider Demographics
NPI:1366420275
Name:TAYLORS DRUG CO INC
Entity type:Organization
Organization Name:TAYLORS DRUG CO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MAXIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:864-244-1513
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:3324 WADE HAMPTON BLVD
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687
Mailing Address - Country:US
Mailing Address - Phone:864-244-1513
Mailing Address - Fax:864-322-6801
Practice Address - Street 1:3324 WADE HAMPTON BLVD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2902
Practice Address - Country:US
Practice Address - Phone:864-244-1513
Practice Address - Fax:864-322-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1529333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC715290Medicaid