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Organization
BOLAND PHARMACY
Active
Organization
BOLAND PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIAN BOLAND (OWNER)
(803) 897-2133
Entity
Organization
Contact information
Practice address
2732 CLEVELAND ST, ELLOREE, SC 29047
(803) 897-2133
(803) 897-2752
Mailing address
PO BOX 50, ELLOREE, SC 29047-0050
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
50001693
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4212293
OTHER ID NUMBER
—
05
—
716933
—
SC
Enumeration date
07/06/2007
Last updated
09/23/2008
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