Individual provider Active NPI

Adrienne Eubanks Bundrick

  • Pharmacist
  • Greenville, SC
National Provider Identifier
1063012128
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
42579 Issued in SC
Practice address
701 Grove Rd
Greenville, SC 29605-4210
Phone
(864) 455-4627
NPI assigned
Oct 28, 2020
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42579 SC Primary

Addresses

Primary practice location

701 Grove Rd
Greenville, SC 29605-4210

Mailing address

312 Shutter Rd
Central, SC 29630-9785

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adrienne.bundrick@prismahealth.org

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

State licenses

LicenseStateTypeSpecialty
42579SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1063012128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 SHUTTER RD",
            "city": "CENTRAL",
            "state": "SC",
            "postal_code": "296309785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDRICK",
        "first_name": "ADRIENNE",
        "middle_name": "EUBANKS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "42579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adrienne.bundrick@prismahealth.org",
            "affiliation": "N",
            "endpointDescription": "secured work email",
            "address_1": "701 Grove Rd",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 28, 2020; 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.