Pharmacy Express Drug Store Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

500009686 Issued in SC

Legal business name

PHARMACY EXPRESS DRUG STORE INC

Practice address

209C South Griffin St
Florence, SC 29506

Phone

(843) 665-9199

Fax

(843) 667-0585

NPI assigned

Oct 11, 2006

Last updated

Aug 19, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Debbie H Simmons, RPH

Title

Pharmacist in Charge Owner

Phone

(843) 665-9199

Specialties & licenses 2

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1033207493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209C SOUTH GRIFFIN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29506",
            "telephone_number": "843-665-9199",
            "fax_number": "843-667-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209C SOUTH GRIFFIN ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29506",
            "telephone_number": "843-665-9199",
            "fax_number": "843-667-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY EXPRESS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE OWNER",
        "authorized_official_telephone_number": "843-665-9199",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SC",
            "license": "500009686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033207493",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4225098",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "796865",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mincy C Peterson, OTR/L
• Telvin Floyd Peterson
• Keith Alex Pettigrew III, PA
• Brian Pettis, ATC, SCAT, CSCS
• Lorrie D. Peyton, FNP
• Pharmacy Express LLC
• Phillip & Coker OB-GYN LLC
• Karen Renee Phillips-Hugine
• Ashton Phillips
• Cynthia Phillips

• Pharmacy in Florence, SC
• Providers in Florence, SC by specialty
• Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.