Organization
GUSTAFSONS APOTHECARY LLC
Active
Other names
Landy's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
YALANDER GAMBLE (OWNER/PHARMACIST)
(803) 738-5706
Entity
Organization
Contact information
Practice address
835 SPARKLEBERRY LANE, COLUMBIA, SC 29229-2922
(803) 567-3107
(803) 736-6228
Mailing address
835 SPARKLEBERRY LANE, COLUMBIA, SC 29229
(803) 567-3107
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
15837
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150419
PK
—
05
—
715837
—
SC
Enumeration date
04/01/2015
Last updated
02/23/2021
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