Organization
MEDICINE MAN PHARMACY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RICHARD MISSROON RPH (PHARMACIST)
(843) 871-6944
Entity
Organization
Contact information
Practice address
404 TROLLEY RD, SUMMERVILLE, SC 29485-5661
(843) 871-6974
(843) 851-9548
Mailing address
404 TROLLEY RD, SUMMERVILLE, SC 29485-5661
(843) 871-6974
(843) 851-9548
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
1568
SC
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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