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General NPI Number Information
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NPI Number | 1144240086
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Entity Type | Organization
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Legal Business Name | GUARDIAN PHARMACY OF SOUTH CAROLINA ONE
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 810 ELIZABETH ST
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City | GEORGETOWN
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State | SC
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Zip | 29440-3964
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Country | US
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Telephone | 843-545-8800
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Fax | 843-545-8803
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Provider Business Mailing Address
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Address Line | 810 ELIZABETH ST
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City | GEORGETOWN
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State | SC
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Zip | 29440-3964
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Country | US
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Telephone | 843-545-8800
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Fax | 843-545-8803
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | AMY L COLVIS
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Credential |
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Telephone | 843-545-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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