| NPI | 1902855984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER GERALD ELLISOR President 803-794-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 50001351) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 50001351) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2011-06-17 |