Ninety Six Pharmacy, Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

3458 Issued in SC

Legal business name

NINETY SIX PHARMACY, INC.

Doing business as

Family Pharmacy

Practice address

206 N Cambridge St
Ninety Six, SC 29666-1011

Phone

(864) 543-2852

Fax

(864) 543-2982

NPI assigned

Jul 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William Hampton Long II, RPH

Title

Owner/Pharmacist

Phone

(864) 543-2852

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Family Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dharmendrakumar B Patel, PHARM D.

  • Pharmacist
  • Ninety Six, SC
  • NPI 1538410394
  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740219732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N CAMBRIDGE ST",
            "city": "NINETY SIX",
            "state": "SC",
            "postal_code": "296661011",
            "telephone_number": "864-543-2852",
            "fax_number": "864-543-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N CAMBRIDGE ST",
            "city": "NINETY SIX",
            "state": "SC",
            "postal_code": "296661011",
            "telephone_number": "864-543-2852",
            "fax_number": "864-543-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINETY SIX PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HAMPTON",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "864-543-2852",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "3458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME330",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "50004038",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Corley Brooks Lyle, COTA/L
• Lisa Wise Miller, RN
• Taylor Miller
• Melissa Dawn Morrison
• Swetha Narala, MD
• Andrew Collier Owings, DMD
• Dharmendrakumar B Patel, PHARM D.
• Mary Pippin, RN
• Self Medical Group
• Self Regional Healthcare (Family Healthcare Ninety Six)

• Pharmacist in Ninety Six, SC
• Providers in Ninety Six, SC by specialty
• Pharmacist in South Carolina

• 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.

Verify at the official NPI Registry.