MEDICARE: HEMINGWAY PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	045034933	SC
2	332BX2000X	Oxygen Equipment & Supplies (DME)	65-005002	SC
3	333600000X	Pharmacy	50-004307	SC
4	332B00000X	Durable Medical Equipment & Medical Supplies	25081096-6	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700862257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMINGWAY PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 887
Second Line	:
City	:	ANDREWS
State	:	SC
Zip	:	29510-0887
Country	:	US
Telephone Number	:	843-264-3357
Fax Number	:	843-264-8188

Provider Business Practice Location Address
First Line	:	13 W OAKLAND ST
Second Line	:
City	:	ANDREWS
State	:	SC
Zip	:	29510-2527
Country	:	US
Telephone Number	:	843-264-3357
Fax Number	:	843-264-8188

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MR. THOMAS O MORRIS
Credential	:	RPH
Telephone Number	:	843-264-3357

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	05/20/2008

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1326176876 — HEMINGWAY PHARMACY, INC
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1134121221 — DR. LARRY T WILSON MD
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1730164229 — DR. BERNARD LEE JONES JR. MD
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1124003074 — DR. ALEXANDER S. HEMINGWAY D.C.
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1750367918 — MRS. JANIS W HARVEY C FNP
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Directions to “HEMINGWAY PHARMACY INC ” Practice Location

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