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General NPI Number Information
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NPI Number | 1902802531
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Entity Type | Organization
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Legal Business Name | JBM LLC
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 822 E LIBERTY ST STE B
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City | YORK
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State | SC
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Zip | 29745-3501
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Country | US
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Telephone | 803-628-7934
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Fax | 803-628-4194
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Provider Business Mailing Address
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Address Line | 822 E LIBERTY ST STE B
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City | YORK
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State | SC
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Zip | 29745-3501
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Country | US
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Telephone | 803-628-7934
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Fax | 803-628-4194
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Authorized Official
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Title or Position | OWNER PIC
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Name | DEBORAH BOWERS
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Credential | PHARMD
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Telephone | 803-628-7934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 8824
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License Number State | SC
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