| NPI | 1023570348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA SAYLES Credentialing Specialist 864-642-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-04 |