Individual
BRENAE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-6482
Mailing address
144 TIMBERGATE RD, LEXINGTON, SC 29073-8833
(803) 404-9064
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
43401
SC
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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