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General NPI Number Information
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NPI Number | 1720070972
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Entity Type | Organization
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Legal Business Name | TLC MEDICAL CENTRE, INC.
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 190 CREPE MYRTLE CT
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City | AIKEN
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State | SC
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Zip | 29803-7543
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Country | US
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Telephone | 803-648-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 190 CREPE MYRTLE CT
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City | AIKEN
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State | SC
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Zip | 29803-7543
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Country | US
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Telephone | 803-648-7800
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Fax |
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Authorized Official
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Title or Position | CHIEF PHARMACIST PRESIDENT
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Name | MS. ZOOM HOANG HEATON
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Credential | RPH, CDE
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Telephone | 803-648-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 50-007024
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 50-007024
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License Number State | SC
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