# M J W CORPORTATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790772598
- **Authorized official:** BRANDI NICOLE JOHNSON PHARM D (PRESIDENT/OWNER/PHARMACIST)
- **Authorized official phone:** (803) 648-1776

## Contact information

- **Practice address:** 333 NEWBERRY ST NW, AIKEN, SC 29801-3929
- **Practice address phone:** (803) 649-1776
- **Practice address fax:** (803) 641-0205
- **Mailing address:** 333 NEWBERRY ST NW, AIKEN, SC 29801-3929
- **Mailing address phone:** (803) 649-1776
- **Mailing address fax:** (803) 641-0205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 2693 | SC | Yes |

## Other

- **Enumeration date:** 10/05/2005
- **Last updated:** 12/05/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2089675 | PK | — |
| 05 | — | 726932 | — | SC |
| 05 | — | DME636 | — | SC |