Provider Demographics
NPI:1114985470
Name:MANNING PHARMACY,INC
Entity Type:Organization
Organization Name:MANNING PHARMACY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:EPPERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-435-4279
Mailing Address - Street 1:311A S MILL ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-2916
Mailing Address - Country:US
Mailing Address - Phone:803-435-4279
Mailing Address - Fax:803-435-4822
Practice Address - Street 1:311A S MILL ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-2916
Practice Address - Country:US
Practice Address - Phone:803-435-4279
Practice Address - Fax:803-435-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDME 485OtherDURABLE MEDICAL NUMBER
SC4213473Medicaid
SC0702620001Medicare ID - Type Unspecified