| NPI | 1962822932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BUNDRICK Pharmacist In Charge 803-509-0114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |