OrganizationActive
Advanced Medical Group, LLC
NPI 1912304197 · Community/Retail Pharmacy · Aiken, SC
Provider details
- NPI number
- 1912304197
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Vance Wall, Ceo / Owner(678) 985-7246
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
- Long Term Care Pharmacy3336L0003X
Suppliers
Practice location
839 Richland Ave W
Aiken, SC 29801-3833
Phone: (803) 649-7437
Fax: (803) 649-2062
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1860
Langley, SC 29834-1860
Other names (DBA / former)
- Doing business as
- Medicine Mart
- Doing business as
- Medicine Mart
Registry dates
- Enumerated
- 2014-12-03
- Last updated
- 2019-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.