Provider Demographics
NPI:1902880289
Name:CHARLES S AIMAR PHARMACY INC
Entity type:Organization
Organization Name:CHARLES S AIMAR PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REG PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:SCHLEY
Authorized Official - Last Name:AIMAR
Authorized Official - Suffix:SR
Authorized Official - Credentials:REG PHARMACIST
Authorized Official - Phone:843-524-9009
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:968 RIBAUT RD SUITE 1
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902
Mailing Address - Country:US
Mailing Address - Phone:843-524-9009
Mailing Address - Fax:843-525-6782
Practice Address - Street 1:968 RIBAUT RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5486
Practice Address - Country:US
Practice Address - Phone:843-524-9009
Practice Address - Fax:843-525-6782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2203183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC715437Medicaid
SC715437Medicaid