Active NPI
John Mark Dubose, PHARMD, RPH
- Pharmacist
- Dillon, SC
National Provider Identifier
1003275983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36446
- Practice address
- 805 Enterprise Rd
Dillon, SC 29536-7821 - Phone
- (843) 841-2228
- NPI assigned
- Feb 19, 2016
- Last updated
- Feb 19, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36446 | SC | Primary |
Addresses
Primary practice location
805 Enterprise Rd
Dillon, SC 29536-7821
Mailing address
805 Enterprise Rd
Dillon, SC 29536-7821
Phone (843) 841-2228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36446 | SC | MD | Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1003275983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 ENTERPRISE RD",
"city": "DILLON",
"state": "SC",
"postal_code": "295367821",
"telephone_number": "843-841-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 ENTERPRISE RD",
"city": "DILLON",
"state": "SC",
"postal_code": "295367821",
"telephone_number": "843-841-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOSE",
"first_name": "JOHN",
"middle_name": "MARK",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-19",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dillon, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.