| NPI | 1366531055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP D MIMS President 803-917-3627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 50009341) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: SC 50007248) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2008-03-21 |