Carolina Health Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CAROLINA HEALTH PHARMACY LLC

Practice address

4036 River Oaks Dr Unit B-1
Myrtle Beach, SC 29579-6695

Phone

(843) 236-6500

Fax

(843) 584-8534

NPI assigned

Aug 20, 2017

Last updated

Apr 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sameh IbrahimNPI 1427220607

Title

Owner

Phone

(843) 215-8200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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.

• Sameh Ibrahim

  • Pharmacist
  • Myrtle Beach, SC
  • NPI 1427220607
  NPD Authorized official

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

{
    "created_epoch": "1503187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1205352374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 RIVER OAKS DR UNIT B-1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796695",
            "telephone_number": "843-236-6500",
            "fax_number": "843-584-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 RIVER OAKS DR UNIT B-1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796695",
            "telephone_number": "843-236-6500",
            "fax_number": "843-584-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTH PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-20",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SAMEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-215-8200"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "717565",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Forest Hearing Center, P.C.
• Carolina Forest Imaging Center LLC
• Carolina Forest Imaging Center LLC
• Carolina Forest Urgent Care LLC
• Carolina Health and Recovery
• Carolina Orthopaedic Specialists
• Carolina Orthotics & Prosthetics of MB LLC
• Carolina Orthotics & Prosthetics of Myrtle Beach LLC
• Carolina Orthotics and Prosthetics LLC
• Carolina Pain and Wellness Inc

• Community/Retail Pharmacy in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.