WALL DRUGS OF JOHNSONVILLE, INC. (NPI# 1245321363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245321363 |
| Entity Type | Organization |
| Organization Name | WALL DRUGS OF JOHNSONVILLE, INC. |
| Practice Address |
239 Stuckey Street Johnsonville SC 29555 |
| Mailing Address |
Po Box 240 Johnsonville SC 29555 |
| Practice Telephone | 8433866135 |
| Practice Fax Number | 8433801025 |
| Mailing Telephone | 8433866135 |
| Mailing Fax Number | 8433801025 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-01-31 |
| Authorized Official Name | MR. DERRICK ALLAN WALL (OWNER RPH) |
| Authorized Official Telephone | 8433866135 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 50006733 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NABP # NCPDP | 4224274 | 01 | |
| SC | 767338 | 05 |
| Street Address |
239 STUCKEY STREET |
| City | JOHNSONVILLE |
| State | SC |
| Zip Code | 29555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518355080 | Carol A. Baker, Dmd, Pa | Clinic/Center | 144 E. Broadway St, Johnsonville, SC 29555 | 2015-01-06 |
| 1275871345 | Florence County School District Five | Skilled Nursing Facility | 156 East Marion Street, Johnsonville, SC 29555 | 2013-01-24 |
| 1295073559 | Florence School District Five | Local Education Agency (LEA) | 156 East Marion St., Johnsonville, SC 29555 | 2013-01-22 |
| 1073802633 | Johnsonville Adult Day Center | Non-emergency Medical Transport (VAN) | 351 S. Midway Highway, Johnsonville, SC 29555 | 2011-04-05 |
| 1235257734 | Johnsonville Rescue Squad and Ambulance Service Inc | Ambulance | 207 East Broadway St, Johnsonville, SC 29555 | 2007-03-26 |
| 1114006897 | Florence County School District Five | Clinic/Center | 237 S. Georgetown Hwy, Johnsonville, SC 29555 | 2006-11-03 |
| 1124119342 | Derrick Allan Wall | Pharmacist | 239 Stuckey St, Johnsonville, SC 29555 | 2006-09-27 |
| 1770682312 | Lower Florence County Hospital | Clinic/Center | 625 S Georgetown Hwy, Johnsonville, SC 29555 | 2006-09-21 |
| 1912001645 | Mcleod Physician Associates II | Clinic/Center | 355 South Georgetown Highway, Johnsonville, SC 29555 | 2006-09-12 |
| 1386688190 | Carol Anne Baker | Dentist | 144 East Broadway St, Johnsonville, SC 29555 | 2006-06-15 |
| Find all providers in zip 29555 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629274063 | Wall Drugs of Johnsonville | Pharmacy | 239 East Stuckey Street, Johnsonville, SC 29555-0545 | 2007-06-22 |
| 1386676229 | Freds Stores of Tennessee Inc | Pharmacy | 198 Stuckey St, Johnsonville, SC 29555-6446 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144840026 | Salubrius Pharmacy, LLC | Pharmacy | 120 Clair Dr, Powdersville, SC 29673-7771 | 2020-04-21 |
| 1073146502 | Greenville Health Corporation | Pharmacy | 115 N Sumter St Ste 220, Sumter, SC 29150-4972 | 2020-02-12 |
| 1043858996 | M Holdings LLC | Pharmacy | 808 Highway 378 Ste A, Lexington, SC 29072-8379 | 2019-12-11 |
| 1033760483 | Eau Claire Cooperative Health Center, Inc. | Pharmacy | 3041 Old Eastover Rd, Eastover, SC 29044-8303 | 2019-09-26 |
| 1467002816 | Black River Pharmacy LLC | Pharmacy | 32a N Williamsburg County Hwy, Kingstree, SC 29556-2433 | 2019-09-18 |
| 1548821457 | Dipti H Patel | Pharmacy | 636 Chartwell Dr, Greer, SC 29650-4787 | 2019-06-23 |
| 1972163350 | Genesis Health Care, Inc | Pharmacy | 211 S Jones Rd Ste A, Olanta, SC 29114-9705 | 2019-06-18 |
| 1013571314 | Publix Super Markets, Inc. | Pharmacy | 730 Hopewell Drive, Charleston-berkeley, SC 29492-7102 | 2019-04-23 |
| 1548769219 | Long's Drugstores of South Carolina, Inc. | Pharmacy | 811 Pendleton St Ste 10, Greenville, SC 29601-3232 | 2018-02-07 |
| 1740788066 | Zivitski Health Group LLC | Pharmacy | 345 W Main Street, Gray Court, SC 29645 | 2018-02-01 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSONVILLE |
| Zip Code | 29555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.