| NPI | 1205202132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRA JONES Pharmacy District Manager 803-331-5105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: SC 36266) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |