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Organization
MEDICINE MART COLUMBIA, INC.
Active
Organization
MEDICINE MART COLUMBIA, INC.
Active
Other names
MEDICINE MART PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW DAVID WALL (OWNER/PHARMACIST-IN-CHARGE)
(803) 231-2003
Entity
Organization
Contact information
Practice address
3729 ROSEWOOD DR, COLUMBIA, SC 29205
(803) 231-2003
(803) 231-2004
Mailing address
3729 ROSEWOOD DR, COLUMBIA, SC 29205-3531
(803) 231-2003
(803) 231-2004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
17915
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71791D
—
SC
Enumeration date
10/07/2006
Last updated
07/03/2018
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