NPIMap

Organization Active NPI

Peach Valley Pharmacy, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Spartanburg, SC
National Provider Identifier
1821139460
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
DE1599 Issued in SC
Legal business name
PEACH VALLEY PHARMACY, INC.
Practice address
2306 Chesnee Hwy
Suite 1
Spartanburg, SC 29303-5500
Phone
(864) 577-0087
Fax
(864) 577-0599
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James H. WestNPI 1477643484
Title
Ceo
Phone
(864) 577-0087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X DE1599 SC Primary

Addresses

Primary practice location

2306 Chesnee Hwy
Suite 1
Spartanburg, SC 29303-5500

Mailing address

2306 Chesnee Hwy
Suite 1
Spartanburg, SC 29303-5500

Other identifiers 2

IdentifierTypeStateIssuer
750351MedicaidSC
DE1599MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Peach Valley Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821139460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 CHESNEE HWY",
            "address_2": "SUITE 1",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293035500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 CHESNEE HWY",
            "address_2": "SUITE 1",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293035500",
            "telephone_number": "864-577-0087",
            "fax_number": "864-577-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH VALLEY PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-577-0087"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "DE1599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "750351",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1599",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • 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.