| NPI | 1225243074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER GERALD ELLISOR Owner 803-794-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: SC 50002216) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |