| NPI | 1154463115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J L DOZIER CEO 803-712-0373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: SC 50001704) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |