NPI | 1164426938 |
---|---|
Entity Type | Organization |
Authorized Contact | JACK B. HODGE President 803-637-6155 |
Organization Subpart ? | No |
Primary Taxonomy | 333600000X Pharmacy (Licence: SC 50-000987) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 50-000987) |
Enumeration Date | 2005-06-09 |
Last Update Date | 2020-08-22 |