NPIMap

Organization Active NPI

H and M Healthcare

  • Community/Retail Pharmacy
  • Wagener, SC
National Provider Identifier
1629463575
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
15838 Issued in SC
Legal business name
H AND M HEALTHCARE
Practice address
123 A Earl Street
Wagener, SC 29164
Phone
(803) 564-7034
NPI assigned
Mar 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Tavia Fogle
Title
Owner
Phone
(803) 247-2133

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 15838 SC Primary

Addresses

Primary practice location

123 A Earl Street
Wagener, SC 29164

Mailing address

PO Box 278
North, SC 29112-0278
Phone (803) 247-2133

Other identifiers 1

IdentifierTypeStateIssuer
2149745OtherPK

Other names 1

  • Tyler Brothers Prescription Shoppe Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gaston Family Pharmacy3 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

123 Earle St S
#A
Wagener, SC 29164
Phone (803) 564-7034

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1629463575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "NORTH",
            "state": "SC",
            "postal_code": "291120278",
            "telephone_number": "803-247-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 A EARL STREET",
            "city": "WAGENER",
            "state": "SC",
            "postal_code": "29164",
            "telephone_number": "803-564-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H AND M HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "FOGLE",
        "authorized_official_first_name": "TAVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-247-2133"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "15838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tyler Brothers Prescription Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wagener, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.