Organization
TOWN AND COUNTRY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANA MARIA HALTIWANGER PHARMD (OWNER)
(803) 644-6721
Entity
Organization
Contact information
Practice address
606 MAIN ST N, NEW ELLENTON, SC 29809-2534
(803) 652-3006
(803) 652-3036
Mailing address
PO BOX 442, NEW ELLENTON, SC 29809-0442
(803) 652-3006
(803) 652-3036
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
010100
SC
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE3078
—
SC
Enumeration date
08/15/2007
Last updated
05/23/2008
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