Provider Demographics
NPI:1114937505
Name:MORGAN'S PHARMACY OF BATESBURG
Entity Type:Organization
Organization Name:MORGAN'S PHARMACY OF BATESBURG
Other - Org Name:OWEN DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-360-9650
Mailing Address - Street 1:501 W RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BATESBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29006-1732
Mailing Address - Country:US
Mailing Address - Phone:803-532-6581
Mailing Address - Fax:803-532-0109
Practice Address - Street 1:501 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:BATESBURG
Practice Address - State:SC
Practice Address - Zip Code:29006-1732
Practice Address - Country:US
Practice Address - Phone:803-532-6581
Practice Address - Fax:803-532-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2018-04-25
Deactivation Date:2018-04-11
Deactivation Code:
Reactivation Date:2018-04-25
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC20523336C0003X
SC175163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC251DMEMedicaid
SC720525Medicaid
SC251DMEMedicaid
SC251DMEMedicaid