| NPI | 1255680138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DANIEL ODOM PIC 803-212-7016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 5503) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |