| NPI | 1104830611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIH-PING TUCKER Pharmacist In Charge 843-322-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0904X Clinic/Center Public Health, Federal (Licence: SC 011049) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |