| NPI | 1417341132 |
|---|---|
| Doing Business As | TIDEWATER PHARMACY & COMPOUNDING |
| Entity Type | Organization |
| Authorized Contact | CHAD STRAUGHAN Owner/Pharmacist 478-954-1178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 35780) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2016-02-11 |