Organization Active NPI

Memorial Pharmacy Inc

  • Pharmacy
  • Greenville, SC
National Provider Identifier
1821141920
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
713187 Issued in SC
Legal business name
MEMORIAL PHARMACY INC
Practice address
100A Simpson St
Greenville, SC 29605-4413
Phone
(864) 295-1113
Fax
(864) 295-4419
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Mr. Carl David Hill Jr., BSRPH.
Title
Pharmacist
Phone
(864) 295-1113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 713187 SC Primary

Addresses

Primary practice location

100A Simpson St
Greenville, SC 29605-4413

Mailing address

100A Simpson St
Greenville, SC 29605-4413
Phone (864) 295-1113

Other identifiers 1

IdentifierTypeStateIssuer
713187MedicaidSC

National Provider Directory

National Provider Directory

Locations

100 Simpson St
Unit A
Greenville, SC 29605
Phone (864) 295-1113

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1821141920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100A SIMPSON ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054413",
            "telephone_number": "864-295-1113",
            "fax_number": "864-295-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100A SIMPSON ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054413",
            "telephone_number": "864-295-1113",
            "fax_number": "864-295-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "864-295-1113",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "BSRPH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SC",
            "license": "713187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713187",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 28, 2007; 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.