| NPI | 1245081520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL E PRESCOTT Managing Member 864-585-3850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |