Organization
BOLAND PHARMACY 2
Active
Other names
BOLAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH RICKENBACKER RPH (PHARM)
(843) 462-7646
Entity
Organization
Contact information
Practice address
108 W MAIN ST, HARLEYVILLE, SC 29448
(843) 462-7646
(843) 462-7646
Mailing address
PO BOX 96, HARLEYVILLE, SC 29448-0096
(843) 462-7646
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
428
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2087926
PK
—
05
—
SC704285
—
SC
Enumeration date
12/27/2006
Last updated
02/21/2017
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