Individual
DR. JUSTIN HARLEY BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
301 W THOMAS ST, LAKE CITY, SC 29560-3243
(843) 394-5434
Mailing address
301 W THOMAS ST, LAKE CITY, SC 29560-3243
(843) 394-5434
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13474
SC
183500000X
Pharmacist
PS47956
FL
Other
Enumeration date
09/22/2011
Last updated
12/04/2014
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