| NPI | 1750835195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DONJON Supervisor 843-626-3951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: SC 36537) |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2016-08-13 |