| NPI | 1417316548 |
|---|---|
| Doing Business As | TIDEWATER PHARMACY & COMPOUNDING |
| Entity Type | Organization |
| Authorized Contact | CHAD LOUIS STRAUGHAN Owner/Pharmacist 842-375-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: SC 15890) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |