Individual
IMADE ETHEL AIMUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 SUNSET BLVD, WEST COLUMBIA, SC 29169-4717
(803) 796-8126
Mailing address
PO BOX 2071, LEXINGTON, SC 29071-2071
(141) 335-5388
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
033.0003378
VT
183500000X
Pharmacist
23896
MA
183500000X
Pharmacist
Primary
42809
SC
Other
Enumeration date
02/12/2021
Last updated
02/12/2021
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