Palmetto Specialty Pharm LLC

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

Legal business name

PALMETTO SPECIALTY PHARM LLC

Practice address

1200 Two Island CT Unit B
Mount Pleasant, SC 29466-7418

Phone

(843) 972-7704

Fax

(843) 972-9395

NPI assigned

Oct 27, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Joseph Fennick, PHARMD

Title

Ceo

Phone

(843) 972-7704

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palmetto Pharm Doing business as

Electronic endpoints 1

Tax ID family

Palmetto Pharm3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Palmetto Specialty Pharm LLC

  • Community/Retail Pharmacy
  • Mount Pleasant, SC
  • NPI 1114643749
  NPD tax ID
• Palmetto Specialty Pharm LLC

  • Mail Order Pharmacy
  • Mount Pleasant, SC
  • NPI 1164149563
  NPD tax ID

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1134846322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 TWO ISLAND CT UNIT B",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294667418",
            "telephone_number": "843-972-7704",
            "fax_number": "843-972-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 TWO ISLAND CT UNIT B",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294667418",
            "telephone_number": "843-972-7704",
            "fax_number": "843-972-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO SPECIALTY PHARM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "FENNICK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-972-7704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA PHARMACY LICENSE",
            "identifier": "20906",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.pamettopharm.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 Two Island Ct Unit B",
            "city": "Mount Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294667418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Palmetto Pharm",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Palmetto Podiatry P.a.
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Primary Care Physicians, LLC
• Palmetto Specialty Pharm LLC
• Palmetto Specialty Pharm LLC
• Palmetto Therapeutic Medicine LLC
• Palmetto Women'S Health, PC
• Palmetto Women'S Health, PC
• Alice Johanna Palumbo, RT (R) (MR)

• Specialty Pharmacy in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Specialty Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.