Provider Demographics
NPI:1720076540
Name:MJW CORPORATION
Entity Type:Organization
Organization Name:MJW CORPORATION
Other - Org Name:AIKEN COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:II
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-599-1776
Mailing Address - Street 1:110 PRICE AVENUE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7395
Mailing Address - Country:US
Mailing Address - Phone:803-648-1313
Mailing Address - Fax:803-649-9494
Practice Address - Street 1:110 PRICE AVENUE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7395
Practice Address - Country:US
Practice Address - Phone:803-648-1313
Practice Address - Fax:803-649-9494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MJW CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-06
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42250503336C0004X
SC50-0073273336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4225050OtherNABP AIKEN CMPD PHAR
SC50-007327OtherPHARM LICENSE- SC
SC50-007327OtherSC LLR PHARMACY BD
SC50-007327OtherSC LLR PHARMACY BD