Active NPI
Blacks Drug Store, Inc
- Durable Medical Equipment & Medical Supplies
- Chester, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- BLACKS DRUG STORE, INC
- Practice address
- 121 Church St
Chester, SC 29706-2903 - Phone
- (803) 581-2102
- Fax
- (803) 581-2121
- NPI assigned
- May 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert Keels Wylie, PHARM
- Title
- President
- Phone
- (803) 581-2102
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
121 Church St
Chester, SC 29706-2903
Mailing address
121 Church St
Chester, SC 29706-2903
Phone (803) 581-2102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EN2035 | Medicaid | SC |
National Provider Directory
National Provider Directory- Tax ID family
- Blacks Drug Store Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Chester, SC
- NPI 1760678361
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Chester, SC
- NPI 1114063773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1194927459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 CHURCH ST",
"city": "CHESTER",
"state": "SC",
"postal_code": "297062903",
"telephone_number": "803-581-2102",
"fax_number": "803-581-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 CHURCH ST",
"city": "CHESTER",
"state": "SC",
"postal_code": "297062903",
"telephone_number": "803-581-2102",
"fax_number": "803-581-2121"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLACKS DRUG STORE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-31",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WYLIE",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "KEELS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "803-581-2102",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHARM"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EN2035",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chester, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.