Organization
TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Active
Organization
TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Active
Other names
Tidewater Pharmacy & Compounding
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD STRAUGHAN PHARMD (OWNER/PHARMACIST)
(843) 375-6310
Entity
Organization
Contact information
Practice address
421 JOHNNIE DODDS BLVD, STE 100, MOUNT PLEASANT, SC 29464-3052
(843) 375-6310
(843) 375-6311
Mailing address
421 JOHNNIE DODDS BLVD, STE 100, MOUNT PLEASANT, SC 29464-2689
(843) 375-6310
(843) 375-6311
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
35780
SC
Other
Enumeration date
03/19/2015
Last updated
01/31/2016
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