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Organization

NATIONAL DIRECT HOME PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN T CROCKER (VP-OPERATIONS)
(803) 731-0203
Entity
Organization

Contact information

Practice address
317 ZIMALCREST DR, COLUMBIA, SC 29210-6833
(803) 731-0203
(803) 731-0086
Mailing address
317 ZIMALCREST DR, COLUMBIA, SC 29210-6833
(803) 731-0203
(803) 731-0086

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
787655
SC
Enumeration date
09/14/2006
Last updated
11/23/2009
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