| NPI | 1366841231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DONJON Pharmacy Supervisor 843-626-3951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35452) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03131744) |
| Enumeration Date | 2014-08-17 |
| Last Update Date | 2014-08-17 |