Individual
ROSS FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8921 TWO NOTCH RD, COLUMBIA, SC 29223-6367
(803) 736-4945
Mailing address
827 RICKENBAKER RD, COLUMBIA, SC 29205-2149
(803) 760-8288
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36860
SC
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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