| NPI | 1104558808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY KEENEY Pharmacist In Charge 803-445-5224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |