1417382045 NPI number — SIMPLICITY PHARMACY SERVICES,PC

Table of content: MRS. FLORENCE GEORGETTE BROWN L.P.N. (NPI 1750585949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417382045 NPI number — SIMPLICITY PHARMACY SERVICES,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIMPLICITY PHARMACY SERVICES,PC
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:
Provider Other Organization Name Type Code:
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:
1417382045
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 ATRIUM WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29223-6301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-419-8916
Provider Business Mailing Address Fax Number:
803-865-9110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 ATRIUM WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29223-6301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-419-8916
Provider Business Practice Location Address Fax Number:
803-865-9110
Provider Enumeration Date:
09/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RUSS
Authorized Official First Name:
SABRINA
Authorized Official Middle Name:
N
Authorized Official Title or Position:
PRESIDENT/PHARMACIST
Authorized Official Telephone Number:
803-419-8916

Provider Taxonomy Codes

  • Taxonomy code: 1835G0303X , with the licence number:  10006 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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