Provider Demographics
NPI:1447941661
Name:OLANTA PHARMACY
Entity type:Organization
Organization Name:OLANTA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:843-396-4431
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:OLANTA
Mailing Address - State:SC
Mailing Address - Zip Code:29114-0428
Mailing Address - Country:US
Mailing Address - Phone:843-396-4431
Mailing Address - Fax:843-370-0013
Practice Address - Street 1:223 N JONES RD
Practice Address - Street 2:
Practice Address - City:OLANTA
Practice Address - State:SC
Practice Address - Zip Code:29114
Practice Address - Country:US
Practice Address - Phone:843-396-4431
Practice Address - Fax:843-370-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy