South Church Health Mart Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10246 Issued in SC

Legal business name

SOUTH CHURCH HEALTH MART PHARMACY LLC

Doing business as

South Church Health Mart Pharmacy LLC

Practice address

550 S Church St
Unit #9
Spartanburg, SC 29306-3306

Phone

(864) 596-4501

Fax

(864) 596-4503

NPI assigned

May 13, 2008

Organization subpart

No

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

Authorized official

Name

Diandra Brooks, PHRMD

Title

Managing Member

Phone

(864) 641-5351

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• SOUTH CHURCH HEALTH MART PHARMACY LLC Doing business as

Locations

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1073780623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S CHURCH ST",
            "address_2": "UNIT #9",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063306",
            "telephone_number": "864-596-4501",
            "fax_number": "864-596-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S CHURCH ST",
            "address_2": "UNIT #9",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063306",
            "telephone_number": "864-596-4501",
            "fax_number": "864-596-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CHURCH HEALTH MART PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "DIANDRA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "864-641-5351",
        "authorized_official_credential": "PHRMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "10246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4227751",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH CHURCH HEALTH MART PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.