Provider Demographics
NPI:1184791469
Name:NEW HORIZON PHARMACY
Entity type:Organization
Organization Name:NEW HORIZON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-729-8330
Mailing Address - Street 1:130 MALLARD ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4046
Mailing Address - Country:US
Mailing Address - Phone:864-233-1534
Mailing Address - Fax:864-233-7965
Practice Address - Street 1:130 MALLARD ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4046
Practice Address - Country:US
Practice Address - Phone:864-233-1534
Practice Address - Fax:864-233-7965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC500049963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4222092OtherNCPDP
SC749966Medicaid
BG6068046OtherDEA