| NPI | 1689868325 |
|---|---|
| Doing Business As | MEDICINE MAN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ALBERT WALTER JETER Owner 843-367-1164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: SC 1568) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2026-07-08 |