| NPI | 1669720215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTY MARK BROWNLEE Pharmacist In Charge 843-216-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: SC 203649684) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |