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1356691687
FREDERICK SAMUEL LONG
COLUMBIA, SC
NPI
1356691687
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: SC 4465)
Enumeration Date
2012-09-13
Last Update Date
2012-09-13
Business Address
Mr. FREDERICK SAMUEL LONG
3312 DEVINE STREET
COLUMBIA, SC 29205-1850
Phone number: 803-748-8588
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Mailing Address
Mr. FREDERICK SAMUEL LONG
3312 ELLISON ROAD
COLUMBIA, SC 29205-1850
Phone number: 803-748-8588
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