Active NPI
Bobby Tanner
- Pharmacist
- Mullins, SC
National Provider Identifier
1992124259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8580
- Practice address
- 305 Commerce Dr
Mullins, SC 29574-6241 - Phone
- (843) 423-7510
- Fax
- (843) 423-9242
- NPI assigned
- Apr 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 8580 | SC | Primary |
Addresses
Primary practice location
305 Commerce Dr
Mullins, SC 29574-6241
Mailing address
486 Greenview Dr
Johnsonville, SC 29555-6605
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8580 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397520000000",
"number": "1992124259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "486 GREENVIEW DR",
"city": "JOHNSONVILLE",
"state": "SC",
"postal_code": "295556605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 COMMERCE DR",
"city": "MULLINS",
"state": "SC",
"postal_code": "295746241",
"telephone_number": "843-423-7510",
"fax_number": "843-423-9242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "BOBBY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-15",
"last_updated": "2014-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "8580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mullins, SC
- South Carolina Podiatric Physicians and Surgeons Group, LLC
- Daniel Jason Spivey
- Springlake Medical Transport, LLC
- Kenneth Carl Staples Jr., D.O.
- State of South Carolina
- Deidre Ann Tarte
- Chadwick V. Thomas, M.D.
- Erica Rabon Thompkins, RN, FNP STUDENT
- Kathy J Thompkins, APRN
- Chelsea Nicole Thompson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.