Healthcare Provider Details

I. General information

NPI: 1114937505
Provider Name (Legal Business Name): MORGAN'S PHARMACY OF BATESBURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date: 04/11/2018
Reactivation Date: 04/25/2018

III. Provider practice location address

501 W RAILROAD AVE
BATESBURG SC
29006-1732
US

IV. Provider business mailing address

501 W RAILROAD AVE
BATESBURG SC
29006-1732
US

V. Phone/Fax

Practice location:
  • Phone: 803-532-6581
  • Fax: 803-532-0109
Mailing address:
  • Phone: 803-532-6581
  • Fax: 803-532-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2052
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number17516
License Number StateSC

VIII. Authorized Official

Name: REBECCA B MORGAN
Title or Position: OWNER
Credential:
Phone: 803-360-9650