NPIMap

Organization Active NPI

South Carolina Department of Mental Health

  • Long Term Care Pharmacy
  • Columbia, SC
National Provider Identifier
1043365703
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
50001783 Issued in SC
Legal business name
SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Practice address
2200 Harden St.
Columbia, SC 29203-7107
Phone
(803) 737-5339
Fax
(803) 737-5436
NPI assigned
Jan 24, 2007
Organization subpart
Yes
Parent organization
SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Kimberly Butterfly Rudd, M.D.
Title
Director of Professional Services
Phone
(803) 737-5301

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 50001783 SC
Skilled Nursing Facility 314000000X 50-001783 SC
Inpatient Hospice 315D00000X 50001783 SC
Nursing Facility Supplies (DME) 332BN1400X 50001783 SC
Pharmacy 333600000X 50001783 SC
Long Term Care Pharmacy 3336L0003X 50001783 SC Primary

Addresses

Primary practice location

2200 Harden St.
Columbia, SC 29203-7107

Mailing address

2200 Harden St.
Columbia, SC 29203-7107
Phone (803) 737-5339

Other identifiers 1

IdentifierTypeStateIssuer
4212875OtherSCNCPDP

Other names 1

  • C.M.Tucker,Jr Nursing Care Center Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Lexington Co Comm Men H61 organizations share this tax ID, including this one
Part of
Lexington Co Comm Men H

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1043365703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 HARDEN ST.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292037107",
            "telephone_number": "803-737-5339",
            "fax_number": "803-737-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HARDEN ST.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292037107",
            "telephone_number": "803-737-5339",
            "fax_number": "803-737-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH",
        "enumeration_date": "2007-01-24",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "BUTTERFLY",
        "authorized_official_title_or_position": "DIRECTOR OF PROFESSIONAL SERVICES",
        "authorized_official_telephone_number": "803-737-5301",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "SC",
            "license": "50001783",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "50-001783",
            "primary": false
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "SC",
            "license": "50001783",
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "SC",
            "license": "50001783",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SC",
            "license": "50001783",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "SC",
            "license": "50001783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4212875",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C.M.Tucker,Jr Nursing Care Center Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.