# MED MART WECO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICINE MART OF WEST COLUMBIA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598858987
- **Authorized official:** MICHAEL ADAM GLEATON (OWNER)
- **Authorized official phone:** (803) 957-5969

## Contact information

- **Practice address:** 1300 SUNSET BLVD, WEST COLUMBIA, SC 29169-5914
- **Practice address phone:** (803) 791-7043
- **Practice address fax:** (803) 796-1519
- **Mailing address:** 1300 SUNSET BLVD, WEST COLUMBIA, SC 29169-5914
- **Mailing address phone:** (803) 791-7043
- **Mailing address fax:** (803) 796-1519

## Taxonomy

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

## Other

- **Enumeration date:** 09/30/2006
- **Last updated:** 12/06/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 717584 | — | SC |