| NPI | 1558572362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDY MUBARAK Pharmacist 803-438-5735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 50002037) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |