# BEAUFORT PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beaufort Pharmacy and Compouding
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962861922
- **Authorized official:** JEREMY SIMMONS PHARMD (OWNER/PHARMACIST)
- **Authorized official phone:** (843) 379-3278

## Contact information

- **Practice address:** 968 RIBAUT RD STE 1, BEAUFORT, SC 29902-8003
- **Practice address phone:** (843) 379-3278
- **Practice address fax:** (843) 379-3232
- **Mailing address:** 968 RIBAUT RD, SUITE 1, BEAUFORT, SC 29902-8000
- **Mailing address phone:** (843) 379-3278
- **Mailing address fax:** (843) 379-3232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 16473 | SC | Yes |

## Other

- **Enumeration date:** 02/18/2016
- **Last updated:** 12/01/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2159036 | PK | — |
| 05 | — | 716473 | — | SC |