Organization Active NPI

Timmonsville Drug Inc

Doing business as Timmonsville Pharmacy

  • Community/Retail Pharmacy
  • Timmonsville, SC
National Provider Identifier
1083675391
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
4683 Issued in SC
Legal business name
TIMMONSVILLE DRUG INC
Doing business as
Timmonsville Pharmacy
Practice address
309 E Smith St
Timmonsville, SC 29161-1821
Phone
(843) 346-5410
Fax
(843) 346-5414
NPI assigned
Mar 28, 2006
Last updated
Aug 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

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

Authorized official

Name
Douglas Moore
Title
Treasurer Mang
Phone
(843) 346-5410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 4683 SC Primary

Addresses

Primary practice location

309 E Smith St
Timmonsville, SC 29161-1821

Mailing address

309 E Smith St
Timmonsville, SC 29161-1821
Phone (843) 346-5410

Other identifiers 2

IdentifierTypeStateIssuer
746837MedicaidSC
4216568OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • TIMMONSVILLE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

309 E Smith St
Timmonsville, SC 29161
Phone (843) 346-5410

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1083675391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E SMITH ST",
            "city": "TIMMONSVILLE",
            "state": "SC",
            "postal_code": "291611821",
            "telephone_number": "843-346-5410",
            "fax_number": "843-346-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E SMITH ST",
            "city": "TIMMONSVILLE",
            "state": "SC",
            "postal_code": "291611821",
            "telephone_number": "843-346-5410",
            "fax_number": "843-346-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMMONSVILLE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "TREASURER MANG",
        "authorized_official_telephone_number": "843-346-5410"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "4683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "746837",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4216568",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TIMMONSVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Timmonsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.