Provider Demographics
NPI:1003858648
Name:CAPSULES INC
Entity Type:Organization
Organization Name:CAPSULES INC
Other - Org Name:APOTHECARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-532-7222
Mailing Address - Street 1:134 E COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-8004
Mailing Address - Country:US
Mailing Address - Phone:803-532-7222
Mailing Address - Fax:803-532-9876
Practice Address - Street 1:134 E COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-8004
Practice Address - Country:US
Practice Address - Phone:803-532-7222
Practice Address - Fax:803-332-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC500046693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC728736Medicaid
2090443OtherPK
1272360001Medicare NSC