Organization
CHARLESTON ENT ASSOCIATES LLC
Active
Other names
Charleston ENT Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES VECCHIOLLA (DIRECTOR OF PHARMACY)
(843) 793-6402
Entity
Organization
Contact information
Practice address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 793-6402
(866) 227-6107
Mailing address
2295 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7801
(843) 793-6402
(866) 227-6107
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
13762
SC
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133463
PK
—
Enumeration date
12/30/2011
Last updated
04/25/2016
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