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Organization

VISTARA COLUMBIA LLC

Active
Other names
vistara pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MONANK PATEL (PHARMACIST MANAGER)
(803) 662-5478
Entity
Organization

Contact information

Practice address
1120 SPARKLEBERRY LANE EXT STE D, COLUMBIA, SC 29223-7078
(803) 680-4714
(803) 335-5158
Mailing address
1120 SPARKLEBERRY LANE EXT STE D, COLUMBIA, SC 29223-7078
(803) 680-4714
(803) 335-5158

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
04/19/2023
Last updated
09/27/2023
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