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Organization
COMPOUNDING CENTER AT THE TIDES
Active
Organization
COMPOUNDING CENTER AT THE TIDES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMERALD TODD (MEDICAL ASSISTANT)
(843) 400-4060
Entity
Organization
Contact information
Practice address
180 WINGO WAY STE 106, MOUNT PLEASANT, SC 29464-1810
(843) 400-4060
Mailing address
180 WINGO WAY STE 106, MOUNT PLEASANT, SC 29464-1810
(843) 400-4060
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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