1497847214 NPI number — OCONEE APOTHECARIES INC

Table of content: (NPI 1497847214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497847214 NPI number — OCONEE APOTHECARIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OCONEE APOTHECARIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SAMMETH DRUG
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497847214
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
115 N TOWNVILLE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SENECA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29678-3254
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-882-3301
Provider Business Mailing Address Fax Number:
864-882-5015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 N TOWNVILLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29678-3254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-882-3301
Provider Business Practice Location Address Fax Number:
864-882-5015
Provider Enumeration Date:
09/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAGAHA
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER AND PRESIDENT
Authorized Official Telephone Number:
864-882-3301

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 50002232 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 722320 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4200060 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".