| NPI | 1033207493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE H SIMMONS Pharmacist In Charge Owner 843-665-9199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 500009686) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-08-19 |