Provider First Line Business Practice Location Address:
4611 HARD SCRABBLE RD
Provider Second Line Business Practice Location Address:
PHARMACY
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29229-8584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-736-9599
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2007