Organization Active NPI

Laurel Pharmacy Inc.

  • Community/Retail Pharmacy
  • Columbia, SC
National Provider Identifier
1154330926
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
50-005847 Issued in SC
Legal business name
LAUREL PHARMACY INC.
Practice address
2761 Laurel St
Columbia, SC 29204-2021
Phone
(803) 254-2761
Fax
(803) 779-2515
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
Mrs. Kristie Cassidy, RPH
Title
Vice-President
Phone
(803) 227-4464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 50-005847 SC Primary

Addresses

Primary practice location

2761 Laurel St
Columbia, SC 29204-2021

Mailing address

2761 Laurel St
Columbia, SC 29204-2021
Phone (803) 254-2761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130821000397 SC Part B Supplier - Mass Immunization (Roster Biller Only) 8820231954 Practice locations: Columbia, SC

National Provider Directory

National Provider Directory
Tax ID family
Laurel Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1154330926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 LAUREL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042021",
            "telephone_number": "803-254-2761",
            "fax_number": "803-779-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 LAUREL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042021",
            "telephone_number": "803-254-2761",
            "fax_number": "803-779-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "CASSIDY",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "803-227-4464",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "50-005847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.