| NPI | 1659360873 |
|---|---|
| Former Legal Business Name | CYPRESS CENTER LTC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SAMUEL FULTON ERVIN Sr VP And CFO 843-777-2910 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 16726) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2019-02-25 |