Provider Demographics
NPI:1275025942
Name:PREFERRED PHARMACY LLC
Entity Type:Organization
Organization Name:PREFERRED PHARMACY LLC
Other - Org Name:PREFERRED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:843-227-3501
Mailing Address - Street 1:10911 N JACOB SMART BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-2729
Mailing Address - Country:US
Mailing Address - Phone:843-227-3501
Mailing Address - Fax:843-547-1155
Practice Address - Street 1:10911 N JACOB SMART BLVD STE E
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-2729
Practice Address - Country:US
Practice Address - Phone:843-227-3501
Practice Address - Fax:843-547-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy