Organization
PROFESSIONAL PHARMACY OF MARION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS E FULLER RPH (OWNER/PHARMACIST)
(843) 423-1882
Entity
Organization
Contact information
Practice address
223 N MAIN ST, MARION, SC 29571-3025
(843) 423-1882
(843) 423-5006
Mailing address
223 N MAIN ST, MARION, SC 29571-3025
(843) 423-1882
(843) 423-5006
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
DPE023
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DPE023
—
SC
Enumeration date
11/08/2007
Last updated
11/08/2007
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