Individual
AMY E ZORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
12935 MAIN ST, WILLISTON, SC 29853-2321
(803) 266-3356
(803) 266-3358
Mailing address
12935 MAIN ST, WILLISTON, SC 29853-2321
(803) 266-3356
(803) 266-3358
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
16197
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9165
SCBOP
SC
Enumeration date
09/21/2017
Last updated
06/16/2018
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