Organization
RANDY B BOLAND
Active
Other names
BOLAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN BOLAND RPH (RPH)
(803) 829-2547
Entity
Organization
Contact information
Practice address
715 S HARRY C RAYSOR DR, ST MATTHEWS, SC 29135
(803) 655-7753
(803) 655-7754
Mailing address
PO BOX 235, SAINT MATTHEWS, SC 29135-0235
(803) 655-7753
(803) 655-7754
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3440
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090808
PK
—
05
—
734407
—
SC
Enumeration date
11/08/2006
Last updated
03/07/2017
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