1831266592 NPI number — NEW HORIZON PHARMACY #2

Table of content: DR. ROBERT HUTCHINS DO (NPI 1487813846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831266592 NPI number — NEW HORIZON PHARMACY #2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HORIZON PHARMACY #2
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831266592
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
811 PENDLETON ST
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29601-3209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-751-3200
Provider Business Mailing Address Fax Number:
864-751-3218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
811 PENDLETON ST
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29601-3209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-751-3200
Provider Business Practice Location Address Fax Number:
864-751-3218
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GAFFNEY
Authorized Official First Name:
J BRANDON
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO & PRESIDENT
Authorized Official Telephone Number:
864-729-8330

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  50006758 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 767588 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4224399 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".




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