Mauldin Family Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1874 Issued in SC

Legal business name

MAULDIN FAMILY PHARMACY INC

Practice address

505 N Main St
Ste a
Mauldin, SC 29662-2345

Phone

(864) 288-2600

Fax

(864) 288-5608

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Charles Tidmarsh, RPH

Title

President

Phone

(864) 288-2600

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MAULDIN FAMILY PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1750489688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N MAIN ST",
            "address_2": "STE A",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622345",
            "telephone_number": "864-288-2600",
            "fax_number": "864-288-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N MAIN ST",
            "address_2": "STE A",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622345",
            "telephone_number": "864-288-2600",
            "fax_number": "864-288-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAULDIN FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "TIDMARSH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-288-2600",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "1874",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2089291",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718748",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAULDIN FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.