NPIMap

Organization Active NPI

Genesis Healthcare, Inc

Doing business as Professional Pharmacy of Walterboro

  • Community/Retail Pharmacy
  • Walterboro, SC
National Provider Identifier
1083495030
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GENESIS HEALTHCARE, INC
Doing business as
Professional Pharmacy of Walterboro
Practice address
830 Robertson Blvd
Walterboro, SC 29488-3081
Phone
(843) 510-5523
Fax
(843) 968-0059
NPI assigned
Oct 6, 2023
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESIS HEALTHCARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Tony Megna
Title
Ceo
Phone
(803) 254-3676

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

830 Robertson Blvd
Walterboro, SC 29488-3081

Mailing address

8906 Two Notch Rd
Columbia, SC 29223-6366
Phone (803) 254-3676

Other names 1

  • Professional Pharmacy of Walterboro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Genesis Healthcare Inc13 organizations share this tax ID, including this one
Part of
Genesis Healthcare Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1083495030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 TWO NOTCH RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236366",
            "telephone_number": "803-254-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294883081",
            "telephone_number": "843-510-5523",
            "fax_number": "843-968-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS HEALTHCARE, INC",
        "enumeration_date": "2023-10-06",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "MEGNA",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-254-3676"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Pharmacy of Walterboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.