Provider Demographics
NPI:1306326640
Name:ORANGE CUT RATE DRUG STORE, INC
Entity type:Organization
Organization Name:ORANGE CUT RATE DRUG STORE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:PAGE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-536-0007
Mailing Address - Street 1:PO BOX 701
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-0701
Mailing Address - Country:US
Mailing Address - Phone:803-536-0007
Mailing Address - Fax:803-536-2962
Practice Address - Street 1:1326 GROVE PARK DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115
Practice Address - Country:US
Practice Address - Phone:803-536-0007
Practice Address - Fax:803-536-2962
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORANGE CUT RATE DRUG STORE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-16
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty