Provider Demographics
NPI:1336800689
Name:MORGAN'S PHARMACY OF GILBERT, LLC
Entity type:Organization
Organization Name:MORGAN'S PHARMACY OF GILBERT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-360-9650
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:SC
Mailing Address - Zip Code:29054-0346
Mailing Address - Country:US
Mailing Address - Phone:803-892-5572
Mailing Address - Fax:803-892-2930
Practice Address - Street 1:309 BROAD ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:SC
Practice Address - Zip Code:29054-8587
Practice Address - Country:US
Practice Address - Phone:803-892-5572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORGAN'S PHARMACY OF GILBERT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7Z1074Medicaid