| NPI | 1689756777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DON WALL Owner 864-877-3386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 1074) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |