Organization Active NPI

Kash & Karry Pharmacy, LLC

  • Community/Retail Pharmacy
  • Greenville, SC
National Provider Identifier
1053402891
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
50001875 Issued in SC
Legal business name
KASH & KARRY PHARMACY, LLC
Practice address
101 Pete Hollis Blvd
Greenville, SC 29601-1107
Phone
(864) 232-6711
Fax
(864) 242-4399
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kevan Page, PHARM.DNPI 1174742860
Title
Pharmacist in Charge
Phone
(864) 232-6711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 50001875 SC Primary

Addresses

Primary practice location

101 Pete Hollis Blvd
Greenville, SC 29601-1107

Mailing address

101 Pete Hollis Blvd
Greenville, SC 29601-1107
Phone (864) 232-6711

Other identifiers 3

IdentifierTypeStateIssuer
4213550OtherSCNABP
DME282MedicaidSC
718750MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210527002299 SC Part B Supplier - Mass Immunization (Roster Biller Only) 1456524669 Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Locations

101 Pete Hollis Blvd
Greenville, SC 29601
Phone (864) 232-6711

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053402891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PETE HOLLIS BLVD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296011107",
            "telephone_number": "864-232-6711",
            "fax_number": "864-242-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PETE HOLLIS BLVD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296011107",
            "telephone_number": "864-232-6711",
            "fax_number": "864-242-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KASH & KARRY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "KEVAN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "864-232-6711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "50001875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4213550",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME282",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718750",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.