| NPI | 1104924141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVE DUBOSE Pharmacy Manager 803-773-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: SC 50002786) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-08-01 |