Healthcare Provider Details

I. General information

NPI: 1952122467
Provider Name (Legal Business Name): BIOHEALTH RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 SAINT JULIAN PL
COLUMBIA SC
29204-2402
US

IV. Provider business mailing address

1845 SAINT JULIAN PL
COLUMBIA SC
29204-2411
US

V. Phone/Fax

Practice location:
  • Phone: 803-454-0500
  • Fax:
Mailing address:
  • Phone: 803-454-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name: STUART ELLIOTT TOLMAN
Title or Position: PHARMACIST IN CHARGE
Credential: RPH.,DPH.,CPH.
Phone: 803-454-0500