Active NPI
Andy Y Jun, PHARM D
- Pharmacist
- Mullins, SC
National Provider Identifier
1881048361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14323
- Practice address
- 502 Gapway St
Mullins, SC 29574-3414 - Phone
- (843) 464-0118
- Fax
- (843) 464-7375
- NPI assigned
- Apr 20, 2016
- Last updated
- Apr 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14323 | SC | Primary |
Addresses
Primary practice location
502 Gapway St
Mullins, SC 29574-3414
Mailing address
760 Pennywell CT
Columbia, SC 29229-8439
Phone (843) 464-0118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14323 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1881048361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 PENNYWELL CT",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292298439",
"telephone_number": "843-464-0118",
"fax_number": "843-464-7375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 GAPWAY ST",
"city": "MULLINS",
"state": "SC",
"postal_code": "295743414",
"telephone_number": "843-464-0118",
"fax_number": "843-464-7375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUN",
"first_name": "ANDY",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-20",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "14323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mullins, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.