NPIMap

Organization Active NPI

Agape Pharmacy Inc

  • Community/Retail Pharmacy
  • Columbia, SC
National Provider Identifier
1154590289
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
15037 Issued in SC
Legal business name
AGAPE PHARMACY INC
Practice address
1626 Main St Ste B
Ste B
Columbia, SC 29201-2818
Phone
(803) 451-7289
Fax
(803) 451-7394
NPI assigned
Feb 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Stacey Gilliam, PHARM.D
Title
Pharmacist in Charge
Phone
(803) 454-0365

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 15037 SC Primary

Addresses

Primary practice location

1626 Main St Ste B
Ste B
Columbia, SC 29201-2818

Mailing address

1626 Main St
Ste B
Columbia, SC 29201-2818
Phone (803) 451-7289

Other identifiers 2

IdentifierTypeStateIssuer
798421MedicaidSC
2093484OtherPK

Other names 1

  • AGAPE RX Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Agape Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1626 Main St
Ste B
Columbia, SC 29201
Phone (803) 451-7289

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1154590289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 MAIN ST",
            "address_2": "STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012818",
            "telephone_number": "803-451-7289",
            "fax_number": "803-451-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 MAIN ST STE B",
            "address_2": "STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012818",
            "telephone_number": "803-451-7289",
            "fax_number": "803-451-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "803-454-0365",
        "authorized_official_credential": "PHARM.D"
    },
    "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": "15037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798421",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093484",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGAPE RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.