# INDIAN LAND PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carolina Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225287451
- **Authorized official:** VIPUL PATEL PHARM D. (PIC)
- **Authorized official phone:** (803) 578-8801

## Contact information

- **Practice address:** 8437 CHARLOTTE HWY, INDIAN LAND, SC 29707-7587
- **Practice address phone:** (803) 578-8800
- **Practice address fax:** (803) 578-8801
- **Mailing address:** 8437 CHARLOTTE HWY, INDIAN LAND, SC 29707-7587
- **Mailing address phone:** (803) 578-8800
- **Mailing address fax:** (803) 578-8801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 10186 | SC | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/11/2008
- **Last updated:** 06/28/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4228145 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |