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Organization
NINETY SIX PHARMACY, INC.
Active
Organization
NINETY SIX PHARMACY, INC.
Active
Other names
Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM HAMPTON LONG II RPH (OWNER/PHARMACIST)
(864) 543-2852
Entity
Organization
Contact information
Practice address
206 N CAMBRIDGE ST, NINETY SIX, SC 29666-1011
(864) 543-2852
(864) 543-2982
Mailing address
206 N CAMBRIDGE ST, NINETY SIX, SC 29666-1011
(864) 543-2852
(864) 543-2982
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3458
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50004038
STATE LICENSE NUMBER
SC
05
—
DME330
—
SC
Enumeration date
07/02/2006
Last updated
08/22/2020
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