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General NPI Number Information
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NPI Number | 1861820896
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Entity Type | Organization
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Legal Business Name | WHITE PINE LAND COMPANY INC
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 15 WEST ASHLAND STREET
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City | ANDREWS
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State | SC
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Zip | 29510
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Country | US
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Telephone | 843-264-3291
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Fax | 843-264-5425
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Provider Business Mailing Address
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Address Line | 15 WEST ASHLAND STREET
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City | ANDREWS
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State | SC
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Zip | 29510
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Country | US
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Telephone | 843-264-3291
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Fax | 843-264-5425
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Authorized Official
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Title or Position | PHARMACIST / PIC
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Name | DR. HOLLY MORGAN FRALIX
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Credential | PHARMD
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Telephone | 843-264-3291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 13360
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License Number State | SC
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