Specialty Pharmacy Myrtle Beach LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11125 Issued in SC

Legal business name

SPECIALTY PHARMACY MYRTLE BEACH LLC

Practice address

5900 N Kings Hwy Ste C
Myrtle Beach, SC 29577-2326

Phone

(843) 712-1703

Fax

(843) 712-1705

NPI assigned

Jul 28, 2010

Organization subpart

No

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

Authorized official

Name

Billy Wease

Title

Owner

Phone

(704) 913-7450

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Specialty Pharmacy Myrtle Beach Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Derek Hitchcock, PHARMD

  • Pharmacist
  • Myrtle Beach, SC
  • NPI 1487969150
  NPD (past)

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1033423348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 N KINGS HWY STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772326",
            "telephone_number": "843-712-1703",
            "fax_number": "843-712-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N KINGS HWY STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772326",
            "telephone_number": "843-712-1703",
            "fax_number": "843-712-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHARMACY MYRTLE BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "WEASE",
        "authorized_official_first_name": "BILLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-913-7450"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "11125",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4229781",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Pharmacy Myrtle Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Shannon Michelle Spence, FNP
• Bailey Spencer, DO
• Wilma J Spencer, NP
• Catherine Spicer

• All providers in Myrtle Beach, SC
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.