Provider Demographics
NPI:1053402891
Name:KASH & KARRY PHARMACY, LLC
Entity type:Organization
Organization Name:KASH & KARRY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:864-232-6711
Mailing Address - Street 1:101 PETE HOLLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-1107
Mailing Address - Country:US
Mailing Address - Phone:864-232-6711
Mailing Address - Fax:864-242-4399
Practice Address - Street 1:101 PETE HOLLIS BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1107
Practice Address - Country:US
Practice Address - Phone:864-232-6711
Practice Address - Fax:864-242-4399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC500018753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4213550OtherNABP
SCDME282Medicaid
SC718750Medicaid
SC718750Medicaid