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1770644429
CHARLES BLAIR TIDMARSH
MAULDIN, SC
NPI
1770644429
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: SC 004079)
Enumeration Date
2006-12-13
Last Update Date
2007-07-08
Business Address
Mr. CHARLES BLAIR TIDMARSH RPh
505 N MAIN ST
MAULDIN, SC 29662-2345
Phone number: 864-288-2600
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Mailing Address
Mr. CHARLES BLAIR TIDMARSH RPh
104 CHANTEMAR
SIMPSONVILLE, SC 29681-5101
Phone number: 864-458-8699
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