Active NPI
Nye'S Pharmacy Inc.
- Pharmacist
- Conway, SC
National Provider Identifier
1649353475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4203698
- Legal business name
- NYE'S PHARMACY INC.
- Practice address
- 1600 Tenth Avenue
Nye'S Pharmacy Inc
Conway, SC 29526 - Phone
- (843) 248-5015
- Fax
- (843) 488-1942
- NPI assigned
- Oct 23, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4203698 | SC | Primary |
Addresses
Primary practice location
1600 Tenth Avenue
Nye'S Pharmacy Inc
Conway, SC 29526
Mailing address
1600 Tenth Avenue
Nye'S Pharmacy Inc
Conway, SC 29526
Phone (843) 248-5015
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DME166 | Medicaid | SC | |
| 724530 | Medicaid | SC |
National Provider Directory
National Provider Directory- Tax ID family
- Nye'S Pharmacy Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist
- Conway, SC
- NPI 1497877369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1649353475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 TENTH AVENUE",
"address_2": "NYE'S PHARMACY INC",
"city": "CONWAY",
"state": "SC",
"postal_code": "29526",
"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 TENTH AVENUE",
"address_2": "NYE'S PHARMACY INC",
"city": "CONWAY",
"state": "SC",
"postal_code": "29526",
"telephone_number": "843-248-5015",
"fax_number": "843-488-1942"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NYE'S PHARMACY INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-23",
"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 SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "SC",
"license": "4203698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DME166",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "724530",
"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.