| NPI | 1790430429 |
|---|---|
| Other Name | IOD-GSU |
| Entity Type | Organization |
| Authorized Contact | DEBBIE L BOLIG Director Of Revenue Cycle 843-347-2450 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-02-22 |