Healthcare Provider Details

I. General information

NPI: 1700862257
Provider Name (Legal Business Name): HEMINGWAY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 W OAKLAND ST
ANDREWS SC
29510-2527
US

IV. Provider business mailing address

PO BOX 887
ANDREWS SC
29510-0887
US

V. Phone/Fax

Practice location:
  • Phone: 843-264-3357
  • Fax: 843-264-8188
Mailing address:
  • Phone: 843-264-3357
  • Fax: 843-264-8188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number25081096-6
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number045034933
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number65-005002
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number50-004307
License Number StateSC

VIII. Authorized Official

Name: MR. THOMAS O MORRIS
Title or Position: PRESIDENT OWNER
Credential: RPH
Phone: 843-264-3357