Provider Demographics
NPI:1578507349
Name:ANMED HEALTH PHARMACY, OGLESBY CENTER
Entity Type:Organization
Organization Name:ANMED HEALTH PHARMACY, OGLESBY CENTER
Other - Org Name:ANMED HEALTH SERVICES, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-512-1000
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:STE 1000
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-512-6020
Mailing Address - Fax:864-512-6023
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-6020
Practice Address - Fax:864-512-6023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANMED HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-15
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC42-21367Other3RD PARTY PAYER PROVIDER
SC741141Medicaid
SC741141Medicaid