| NPI | 1679519128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN OBRIEN Owner 864-644-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 50005290) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-08-22 |