| NPI | 1235273475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH TRACY Owner 843-549-7716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 2571) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2007-09-13 |