NPIMap

Organization Active NPI

Professional Pharmacy of Greer, Inc

  • Durable Medical Equipment & Medical Supplies
  • Greer, SC
National Provider Identifier
1912126707
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROFESSIONAL PHARMACY OF GREER, INC
Practice address
320 Memorial Dr
Greer, SC 29650-1521
Phone
(864) 877-3386
Fax
(864) 877-3859
NPI assigned
Apr 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Charles Donald Wall, R. PHARMACISTS
Title
Owner
Phone
(864) 877-3386

Specialties & licenses 1

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

Addresses

Primary practice location

320 Memorial Dr
Greer, SC 29650-1521

Mailing address

320 Memorial Dr
Greer, SC 29650-1521
Phone (864) 877-3386

Other identifiers 1

IdentifierTypeStateIssuer
610743MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Professional Pharmacy of Greer 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.

Locations

320 Memorial Dr
Greer, SC 29650
Phone (864) 877-3386

Practitioners & affiliated clinicians

Practitioners 3

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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912126707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MEMORIAL DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501521",
            "telephone_number": "864-877-3386",
            "fax_number": "864-877-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MEMORIAL DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296501521",
            "telephone_number": "864-877-3386",
            "fax_number": "864-877-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY OF GREER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-877-3386",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R. PHARMACISTS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610743",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, 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.