Organization
MED MART WECO LLC
Active
Other names
MEDICINE MART OF WEST COLUMBIA
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ADAM GLEATON (OWNER)
(803) 957-5969
Entity
Organization
Contact information
Practice address
1300 SUNSET BLVD, WEST COLUMBIA, SC 29169-5914
(803) 791-7043
(803) 796-1519
Mailing address
1300 SUNSET BLVD, WEST COLUMBIA, SC 29169-5914
(803) 791-7043
(803) 796-1519
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
717584
—
SC
Enumeration date
09/30/2006
Last updated
12/06/2024
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