Active NPI
Edward R Douglas, RPH
- Pharmacist
- Florence, SC
National Provider Identifier
1063702926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5809
- Practice address
- 1825 W Palmetto St
Florence, SC 29501-4137 - Phone
- (843) 662-2970
- Fax
- (843) 665-2561
- NPI assigned
- Apr 12, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5809 | SC | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | 5809 | SC |
Addresses
Primary practice location
1825 W Palmetto St
Florence, SC 29501-4137
Mailing address
1825 W Palmetto St
Florence, SC 29501-4137
Phone (843) 662-2970
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 |
|---|---|---|---|
| 5809 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1063702926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 W PALMETTO ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295014137",
"telephone_number": "843-662-2970",
"fax_number": "843-665-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 W PALMETTO ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295014137",
"telephone_number": "843-662-2970",
"fax_number": "843-665-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "EDWARD",
"middle_name": "R",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-12",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "5809",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "SC",
"license": "5809",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.