| Provider Type: | Suppliers |
| Provider Classification: | Pharmacy |
| Provider Specialization: | Community/Retail Pharmacy |
| Definition of Specialization: | |
| Address: |
50 E Hospital St Suite 1 Manning, SC 29102-3149 |
| Phone: | (803) 435-5224 |
| Fax: | (803) 435-5227 |
| Authorized Official: | Ferman, Dena |
| Authorized Official Position: | Third Party Plan Coordinator |
| Authorized Official Phone: | (314) 993-6000 |
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