Provider Demographics
NPI:1609943901
Name:NEW HORIZON FAMILY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:NEW HORIZON FAMILY HEALTH SERVICES INC
Other - Org Name:NEW HORIZON PHARMACY #3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:864-233-1534
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-0287
Mailing Address - Country:US
Mailing Address - Phone:864-233-1534
Mailing Address - Fax:864-233-7965
Practice Address - Street 1:111A BERRY AVE
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1307
Practice Address - Country:US
Practice Address - Phone:864-801-2035
Practice Address - Fax:864-416-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC86493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2093062OtherPK
SC786491Medicaid