| NPI | 1295095487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MONIQUE BURKS Pharmacist 843-830-8702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC LIC-1-13-89601) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2013-02-18 |