| NPI | 1508537176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASHYAP B PATEL CEO 803-329-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-09-23 |