Active NPI
Robert John Redzikowski, RPH
- Pharmacist
- North Charleston, SC
National Provider Identifier
1053561563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 043393-1
- Practice address
- 3725 Rivers Ave
Suite 2
North Charleston, SC 29405-7038 - Phone
- (843) 745-8650
- NPI assigned
- Sep 22, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 043393-1 | NY | Primary |
| Pharmacist | 183500000X | 14728 | NC | |
| Pharmacist | 183500000X | PS 30134 | FL |
Addresses
Primary practice location
3725 Rivers Ave
Suite 2
North Charleston, SC 29405-7038
Mailing address
3725 Rivers Ave
Suite 2
North Charleston, SC 29405-7038
Phone (843) 745-8650
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 30134 | FL | MD | Pharmacist |
| 043393-1 | NY | MD | Pharmacist |
| 14728 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222041600000",
"number": "1053561563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3725 RIVERS AVE",
"address_2": "SUITE 2",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294057038",
"telephone_number": "843-745-8650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3725 RIVERS AVE",
"address_2": "SUITE 2",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294057038",
"telephone_number": "843-745-8650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDZIKOWSKI",
"first_name": "ROBERT",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-22",
"last_updated": "2008-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "043393-1",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "14728",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 30134",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.