# RANDY B BOLAND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BOLAND PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972672210
- **Authorized official:** CAROLYN BOLAND RPH (RPH)
- **Authorized official phone:** (803) 829-2547

## Contact information

- **Practice address:** 715 S HARRY C RAYSOR DR, ST MATTHEWS, SC 29135
- **Practice address phone:** (803) 655-7753
- **Practice address fax:** (803) 655-7754
- **Mailing address:** PO BOX 235, SAINT MATTHEWS, SC 29135-0235
- **Mailing address phone:** (803) 655-7753
- **Mailing address fax:** (803) 655-7754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 3440 | SC | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 03/07/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2090808 | PK | — |
| 05 | — | 734407 | — | SC |