NPIMap

Organization Active NPI

Professional Pharmacy of Marion Inc

Doing business as Professional Phcy of Marion Inc

  • Community/Retail Pharmacy
  • Marion, SC
National Provider Identifier
1912095068
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2363 Issued in SC
Legal business name
PROFESSIONAL PHARMACY OF MARION INC
Doing business as
Professional Phcy of Marion Inc
Practice address
223 N Main St
Marion, SC 29571-3025
Phone
(843) 423-1882
Fax
(843) 423-5006
NPI assigned
Oct 11, 2006
Last updated
Sep 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Authorized official

Name
Thomas Fuller, BS PHARMACT
Title
VP
Phone
(843) 423-1882

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 2363 SC Primary

Addresses

Primary practice location

223 N Main St
Marion, SC 29571-3025

Mailing address

PO Box 1109
Marion, SC 29571-1109
Phone (843) 422-1882

Other identifiers 2

IdentifierTypeStateIssuer
4216443OtherNCPDP PROVIDER IDENTIFICATION NUMBER
723632MedicaidSC

Other names 1

  • PROFESSIONAL PHCY OF MARION INC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1912095068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1109",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295711109",
            "telephone_number": "843-422-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "city": "MARION",
            "state": "SC",
            "postal_code": "295713025",
            "telephone_number": "843-423-1882",
            "fax_number": "843-423-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY OF MARION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "843-423-1882",
        "authorized_official_credential": "BS PHARMACT"
    },
    "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": "2363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4216443",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "723632",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL PHCY OF MARION INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.