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Organization
INDIAN LAND PHARMACY
Active
Organization
INDIAN LAND PHARMACY
Active
Other names
Carolina Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VIPUL PATEL PHARM D. (PIC)
(803) 578-8801
Entity
Organization
Contact information
Practice address
8437 CHARLOTTE HWY, INDIAN LAND, SC 29707-7587
(803) 578-8800
(803) 578-8801
Mailing address
8437 CHARLOTTE HWY, INDIAN LAND, SC 29707-7587
(803) 578-8800
(803) 578-8801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
10186
SC
3336C0004X
Compounding Pharmacy
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4228145
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/11/2008
Last updated
06/28/2011
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