Organization Active NPI

Nye'S Pharmacy Inc.

  • Pharmacist
  • Conway, SC
National Provider Identifier
1497877369
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4203698 Issued in SC
Legal business name
NYE'S PHARMACY INC.
Practice address
1600 10TH Ave
Nye'S Pharmacy Inc.
Conway, SC 29526-4112
Phone
(843) 248-5015
Fax
(843) 488-1942
NPI assigned
Apr 4, 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. Samuel Kevin Martin, RPH
Title
Owner Manager Head Pharmacist
Phone
(843) 248-5015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X 4203698 SC Primary

Addresses

Primary practice location

1600 10TH Ave
Nye'S Pharmacy Inc.
Conway, SC 29526-4112

Mailing address

1600 10TH Ave
Nye'S Pharmacy Inc.
Conway, SC 29526-4112
Phone (843) 248-5015

Other identifiers 1

IdentifierTypeStateIssuer
DME166MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Nye'S Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497877369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 10TH AVE",
            "address_2": "NYE'S PHARMACY INC.",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264112",
            "telephone_number": "843-248-5015",
            "fax_number": "843-488-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 10TH AVE",
            "address_2": "NYE'S PHARMACY INC.",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264112",
            "telephone_number": "843-248-5015",
            "fax_number": "843-488-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYE'S PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER MANAGER HEAD PHARMACIST",
        "authorized_official_telephone_number": "843-248-5015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "4203698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME166",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, 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.