| NPI | 1366502007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE CISA Pharmacist 843-881-0478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 50002348) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 50002348) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2014-10-24 |