NPIMap

Organization Active NPI

Upstate Pharmacy Ima

  • Community/Retail Pharmacy
  • Greenville, SC
National Provider Identifier
1730432964
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
14249 Issued in SC
Legal business name
UPSTATE PHARMACY IMA
Doing business as
Upstate Pharmacy IMA
Practice address
1025 Verdae Blvd Ste a
Greenville, SC 29607-4032
Phone
(864) 286-7545
Fax
(864) 455-1350
NPI assigned
Oct 25, 2012
Last updated
Oct 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Steven Ranck
Title
Manager, Pharmacy
Phone
(864) 455-1325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 14249 SC Primary

Addresses

Primary practice location

1025 Verdae Blvd Ste a
Greenville, SC 29607-4032

Mailing address

1025 Verdae Blvd
Suite a
Greenville, SC 29607-4032
Phone (864) 286-7545

Other identifiers 1

IdentifierTypeStateIssuer
4231015OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Upstate Pharmacy IMA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Urgent Treatment Center24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1730432964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 VERDAE BLVD",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074032",
            "telephone_number": "864-286-7545",
            "fax_number": "864-455-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 VERDAE BLVD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074032",
            "telephone_number": "864-286-7545",
            "fax_number": "864-455-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE PHARMACY IMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "RANCK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER, PHARMACY",
        "authorized_official_telephone_number": "864-455-1325"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "14249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4231015",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upstate Pharmacy IMA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.