NPIMap

Organization Active NPI

MJW Corporation

Doing business as Family Pharmacy-South Aiken

  • Community/Retail Pharmacy
  • Aiken, SC
National Provider Identifier
1669615860
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5010379 Issued in SC
Legal business name
MJW CORPORATION
Doing business as
Family Pharmacy-South Aiken
Practice address
110 Price Ave
Aiken, SC 29803-7395
Phone
(803) 648-1776
Fax
(803) 649-9494
NPI assigned
Apr 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Brandi Nicole Johnson, PHARM D
Title
President / Pharmacist / Pic
Phone
(803) 648-1776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5010379 SC Primary

Addresses

Primary practice location

110 Price Ave
Aiken, SC 29803-7395

Mailing address

110 Price Ave
Aiken, SC 29803-7395
Phone (803) 648-1776

Other identifiers 2

IdentifierTypeStateIssuer
710379MedicaidSC
5010379OtherSCSC PHARMACY PERMIT

Other names 1

  • FAMILY PHARMACY-SOUTH AIKEN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wagener Family Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Price Ave
Aiken, SC 29803
Phone (803) 648-1776

NPI Registry JSON

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1669615860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PRICE AVE",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037395",
            "telephone_number": "803-648-1776",
            "fax_number": "803-649-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PRICE AVE",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037395",
            "telephone_number": "803-648-1776",
            "fax_number": "803-649-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJW CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-17",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT / PHARMACIST / PIC",
        "authorized_official_telephone_number": "803-648-1776",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "5010379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710379",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC PHARMACY PERMIT",
            "identifier": "5010379",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY PHARMACY-SOUTH AIKEN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY PHARMACY-SOUTH AIKEN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.