Provider Demographics
NPI:1457450389
Name:HARSEYS PHARMACY
Entity Type:Organization
Organization Name:HARSEYS PHARMACY
Other - Org Name:HARSEYS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:843-537-9991
Mailing Address - Street 1:280 HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-2848
Mailing Address - Country:US
Mailing Address - Phone:843-537-9991
Mailing Address - Fax:843-537-5081
Practice Address - Street 1:280 HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-2848
Practice Address - Country:US
Practice Address - Phone:843-537-9991
Practice Address - Fax:843-537-5081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC90053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC790050Medicaid
2091923OtherPK