Organization Name:  PHIL'S PHARMACY INC


Practice Location:
1061 N FRASER ST  GEORGETOWN, SC 29440 US
Tel: 803-491-9330  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	333600000X	Suppliers Pharmacy	SC	50003278
N	332B00000X	Suppliers Durable Medical Equipment & Medical Supplies	SC
Y	3336C0003X	Suppliers Pharmacy

Other Provider Identifiers:

Issuer	Number	State	Type
	732784	SC	05
DEA #	BM4601616	SC	01
	DME952	SC	05
OTHER ID NUMBER-COMMERCIAL NUMBER	4219398		01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin