# GUSTAFSONS APOTHECARY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Landy's Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558756072
- **Authorized official:** YALANDER GAMBLE (OWNER/PHARMACIST)
- **Authorized official phone:** (803) 738-5706

## Contact information

- **Practice address:** 835 SPARKLEBERRY LANE, COLUMBIA, SC 29229-2922
- **Practice address phone:** (803) 567-3107
- **Practice address fax:** (803) 736-6228
- **Mailing address:** 835 SPARKLEBERRY LANE, COLUMBIA, SC 29229
- **Mailing address phone:** (803) 567-3107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 15837 | SC | Yes |

## Other

- **Enumeration date:** 04/01/2015
- **Last updated:** 02/23/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2150419 | PK | — |
| 05 | — | 715837 | — | SC |