Provider Demographics
NPI:1083782825
Name:MORGAN'S PHARMACY
Entity Type:Organization
Organization Name:MORGAN'S PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-892-5572
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:SC
Mailing Address - Zip Code:29054-0346
Mailing Address - Country:US
Mailing Address - Phone:803-892-5572
Mailing Address - Fax:803-892-2930
Practice Address - Street 1:309 BROAD STREET
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:SC
Practice Address - Zip Code:29054
Practice Address - Country:US
Practice Address - Phone:803-892-5572
Practice Address - Fax:803-892-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDME871Medicaid
SC731610Medicaid
SC731610Medicaid