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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