Individual
BENJAMIN BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3300 WADE HAMPTON BLVD, TAYLORS, SC 29687-2902
(864) 268-9160
Mailing address
307 N ADAIR ST, CLINTON, SC 29325-2405
(803) 318-6395
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36463
SC
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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