Organization
CAROLINA INFUSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA JENNIFER ETHERIDGE PHARMD (CEO)
(843) 645-8288
Entity
Organization
Contact information
Practice address
405 OLD HOUSE RD UNIT 102, RIDGELAND, SC 29936-6946
(843) 645-8288
(843) 645-8289
Mailing address
405 OLD HOUSE RD UNIT 102, RIDGELAND, SC 29936-6946
(843) 645-8288
(843) 645-8289
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
13447
SC
3336C0004X
Compounding Pharmacy
Primary
13447
SC
Other
Enumeration date
02/03/2012
Last updated
10/23/2013
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