Welvista

NPI 1023200441 - Pharmacy - 3336C0003X

NPI Details
NPI 1023200441
Enumeration Date 08/10/2007
Last Updated 06/03/2015
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JUANITA JUANITA
Position CHIEF EXECUTIVE OFFICER
Phone (803) 933-9183
Fax (803) 254-0892
Practice Location
2700 MIDDLEBURG DR STE 108
COLUMBIA SC, 29204-2416, US
Phone (803) 933-9183
Fax (803) 254-0892
Business Location
2700 MIDDLEBURG DR STE 108
COLUMBIA SC, 29204-2416, US
Phone (803) 933-9183
Fax (803) 254-0892
Toxanomy
Taxonomy Code 3336C0003X
License State South Carolina
License Number 10219
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According to our database, Welvista NPI is 1023200441, taxonomy code is 3336C0003X and license number is 10219, license state is located at South Carolina. Welvista physically located at 2700 Middleburg Dr Ste 108, Columbia SC, 29204-2416. NPI Number 1033115704 has the healthcare provider type.

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1023200441 NPI number is provided on an as is basis without warranty of any kind. 1023200441 is maintained by the National Plan & Provider Enumeration System. The contents of Welvista are for informational purposes only.