# VISTARA COLUMBIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** vistara pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336836576
- **Authorized official:** MONANK PATEL (PHARMACIST MANAGER)
- **Authorized official phone:** (803) 662-5478

## Contact information

- **Practice address:** 1120 SPARKLEBERRY LANE EXT STE D, COLUMBIA, SC 29223-7078
- **Practice address phone:** (803) 680-4714
- **Practice address fax:** (803) 335-5158
- **Mailing address:** 1120 SPARKLEBERRY LANE EXT STE D, COLUMBIA, SC 29223-7078
- **Mailing address phone:** (803) 680-4714
- **Mailing address fax:** (803) 335-5158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/19/2023
- **Last updated:** 09/27/2023