Mary Kathryn Johns, PHARMD

Individual provider Active NPI Pharmacist · Woodruff, SC

NPI 1609486455 · NPPES record last updated Aug 6, 2020

Key facts

NPI
1609486455
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
42614 (SC)
Practice address
820 N Main St
Woodruff, SC 29388-9001
Phone
(864) 476-0463
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
42614SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina CVS Pharmacy LLC Past
since Aug 9, 2020
Accepting new patients
South Carolina CVS Pharmacy LLC Past
since Aug 9, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42614 SC Yes

Addresses

Primary practice location

820 N Main St
Woodruff, SC 29388-9001

Mailing address

9 S Penobscot CT
Simpsonville, SC 29681-4315

Other providers in Woodruff, SC

All providers in Woodruff, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.