NPIMap

Organization Active NPI

State of South Carolina

Doing business as SC Department of Public Health

  • Pharmacy
  • Conway, SC
National Provider Identifier
1174969935
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
14615 Issued in SC
Legal business name
STATE OF SOUTH CAROLINA
Doing business as
SC Department of Public Health
Practice address
1931 Industrial Park Rd
Conway, SC 29526-5482
Phone
(843) 915-8820
NPI assigned
May 20, 2013
Last updated
Jul 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Caroline Sojourner, RPH
Title
Pharmacy Director
Phone
(803) 898-0813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 14615 SC Primary

Addresses

Primary practice location

1931 Industrial Park Rd
Conway, SC 29526-5482

Mailing address

2100 Bull St
Columbia, SC 29201-2104
Phone (803) 898-0813

Other identifiers 2

IdentifierTypeStateIssuer
714615MedicaidSC
4224135OtherSCNCPDP

Other names 3

  • SC Department of Public Health Doing business as
  • DHEC Pee Dee Region Pharmacy Other name
  • SCDPH Pee Dee Region Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Scdhec280 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1174969935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BULL ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012104",
            "telephone_number": "803-898-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 INDUSTRIAL PARK RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295265482",
            "telephone_number": "843-915-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF SOUTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-20",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "SOJOURNER",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "803-898-0813",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SC",
            "license": "14615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714615",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4224135",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SC Department of Public Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DHEC Pee Dee Region Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SCDPH Pee Dee Region Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.