Provider Demographics
NPI:1679571996
Name:FORDS DRUGS AND MEDICAL INC
Entity type:Organization
Organization Name:FORDS DRUGS AND MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-585-3341
Mailing Address - Street 1:435 E MAIN ST
Mailing Address - Street 2:SUITE2
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-1981
Mailing Address - Country:US
Mailing Address - Phone:864-585-3325
Mailing Address - Fax:864-583-6497
Practice Address - Street 1:435 E MAIN ST
Practice Address - Street 2:SUITE2
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1981
Practice Address - Country:US
Practice Address - Phone:864-585-3325
Practice Address - Fax:864-583-6497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
SCSC31043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2089043OtherPK
SC731040Medicaid
2089043OtherPK