Individual
SHAYLA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 BULTMAN DR, SUMTER, SC 29150-2514
(803) 305-6192
Mailing address
225 FERNVIEW DR, COLUMBIA, SC 29229-9067
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43369
SC
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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