NPIMap

Organization Active NPI

Longs Drugstores of SC Inc

  • Community/Retail Pharmacy
  • Charleston, SC
National Provider Identifier
1013428176
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17528 Issued in SC
Legal business name
LONGS DRUGSTORES OF SC INC
Practice address
1481 Tobias Gadson Blvd Ste 2D
Charleston, SC 29407-4794
Phone
(843) 996-1496
NPI assigned
Oct 17, 2017
Organization subpart
Yes
Parent organization
LONG'S DRUGSTORES OF SC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Ellis
Title
Corporate Counsel
Phone
(803) 254-5884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 17528 SC Primary

Addresses

Primary practice location

1481 Tobias Gadson Blvd Ste 2D
Charleston, SC 29407-4794

Mailing address

111 Executive Center Dr Ste 228
Columbia, SC 29210-8416
Phone (803) 254-5884

Other names 1

  • Long's Drugs of Charleston Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040614001381 SC Part B Supplier - Mass Immunization (Roster Biller Only) 6103800768 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rock Hill, SC; Greenville, SC; Charleston, SC
O20241126001285 SC Part B Supplier - Pharmacy 6103800768 2 other NPIs on this enrollment
Practice locations: Charleston, SC; Greenville, SC; Rock Hill, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Long'S Drugstores of South Carolina Inc4 organizations share this tax ID, including this one
Part of
Long'S Drugstores of South Carolina Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

111 Executive Center Dr
Ste 228
Columbia, SC 29210

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1013428176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EXECUTIVE CENTER DR STE 228",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108416",
            "telephone_number": "803-254-5884",
            "fax_number": "866-550-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 TOBIAS GADSON BLVD STE 2D",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074794",
            "telephone_number": "843-996-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUGSTORES OF SC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONG'S DRUGSTORES OF SC INC",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CORPORATE COUNSEL",
        "authorized_official_telephone_number": "803-254-5884"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "17528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long's Drugs of Charleston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.