Sup - RX Pharmacy #92

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

SUP - RX PHARMACY #92

Doing business as

Suprx Pharmacy # 92

Practice address

1945 W Palmetto St
Florence, SC 29501-3919

Phone

(843) 673-9107

Fax

(843) 673-9109

NPI assigned

Jan 3, 2013

Last updated

Feb 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Bryan Moody, RPH

Title

Pic

Phone

(843) 673-9107

Specialties & licenses 1

Addresses

Other names 1

• Suprx Pharmacy # 92 Doing business as

Locations

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1184961641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3238",
            "address_2": "1945 WEST PALMETTO ST SUITE 32",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013919",
            "telephone_number": "843-673-9107",
            "fax_number": "843-673-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W PALMETTO ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013919",
            "telephone_number": "843-673-9107",
            "fax_number": "843-673-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUP - RX PHARMACY #92",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "843-673-9107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suprx Pharmacy # 92",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Florence, SC
• Providers in Florence, SC by specialty
• Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.