Gateway Drug Store, Inc.
NPI #1831189679 in Loris, South Carolina
Provider Information
- NPI Number
- 1831189679
- Entity Type
- Organization
- Organization Name
- Gateway Drug Store, Inc.
- Primary Specialty
- Pharmacy
- Enumeration Date
- Oct 24, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3997 MEETING ST
- City
- Loris
- State
- South Carolina
- ZIP Code
- 29569-3053
- Phone
- (843) 756-5134
Authorized Official
- Name
- MR. THOMAS FREDDIE MOORE, RPH.
- Title
- PRESIDENT
- Phone
- (843) 756-5134
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
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