NPIMap

Organization Active NPI

Professional Pharmacy of Marion,Inc

  • Durable Medical Equipment & Medical Supplies
  • Marion, SC
National Provider Identifier
1164628533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
50002363 Issued in SC
Legal business name
PROFESSIONAL PHARMACY OF MARION,INC
Practice address
223 N Main St
Marion, SC 29571-3025
Phone
(843) 423-1882
Fax
(843) 423-5006
NPI assigned
Jun 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Thomas E Fuller, R.PH.
Title
Owner
Phone
(843) 423-1882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 50002363 SC Primary

Addresses

Primary practice location

223 N Main St
Marion, SC 29571-3025

Mailing address

223 N Main St
PO Box 1109
Marion, SC 29571-3025
Phone (843) 423-1882

Other identifiers 1

IdentifierTypeStateIssuer
EN2023OtherSCCLTC

National Provider Directory

National Provider Directory
Tax ID family
Professional Pharmacy of Marion3 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.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164628533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "address_2": "PO BOX 1109",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295713025",
            "telephone_number": "843-423-1882",
            "fax_number": "843-423-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295713025",
            "telephone_number": "843-423-1882",
            "fax_number": "843-423-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY OF MARION,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-423-1882",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "50002363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLTC",
            "identifier": "EN2023",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.