NPIMap

Organization Active NPI

Kellys Family Pharmacy

  • Community/Retail Pharmacy
  • Easley, SC
National Provider Identifier
1811149966
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10227 Issued in SC
Legal business name
KELLYS FAMILY PHARMACY
Practice address
704 Brushy Creek Rd
Easley, SC 29642-2200
Phone
(864) 343-0540
Fax
(864) 343-0543
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Ralph HuntNPI 1437495611
Title
Pic
Phone
(864) 270-1469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 10227 SC Primary

Addresses

Primary practice location

704 Brushy Creek Rd
Easley, SC 29642-2200

Mailing address

704 Brushy Creek Rd
Easley, SC 29642-2200
Phone (864) 343-0540

Other identifiers 2

IdentifierTypeStateIssuer
2117875OtherPK
710227MedicaidSC

Other names 1

  • Kelly's Family Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

704 Brushy Creek Rd
Easley, SC 29642
Phone (864) 270-1469

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1811149966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 BRUSHY CREEK RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296422200",
            "telephone_number": "864-343-0540",
            "fax_number": "864-343-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 BRUSHY CREEK RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296422200",
            "telephone_number": "864-343-0540",
            "fax_number": "864-343-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLYS FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "864-270-1469"
    },
    "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": "10227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2117875",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710227",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelly's Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easley, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.