NPIMap

Organization Active NPI

Pee Dee Family Pharmacy

  • Community/Retail Pharmacy
  • Dillon, SC
National Provider Identifier
1215007398
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10377 Issued in SC
Legal business name
PEE DEE FAMILY PHARMACY
Practice address
608 N 4TH Ave
Dillon, SC 29536-2502
Phone
(843) 841-9003
Fax
(843) 841-9736
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Carl Altmar, PHARM D
Title
Owner
Phone
(843) 841-9003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 10377 SC Primary

Addresses

Primary practice location

608 N 4TH Ave
Dillon, SC 29536-2502

Mailing address

608 N 4TH Ave
Dillon, SC 29536-2502
Phone (843) 841-9003

Other identifiers 2

IdentifierTypeStateIssuer
759794MedicaidSC
4223789OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • PEE DEE HOME MED SUPPLY AND PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pee Dee Home Medical Supply3 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.

Locations

608 N 4th Ave
Dillon, SC 29536
Phone (843) 841-9003

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1215007398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 N 4TH AVE",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362502",
            "telephone_number": "843-841-9003",
            "fax_number": "843-841-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 N 4TH AVE",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362502",
            "telephone_number": "843-841-9003",
            "fax_number": "843-841-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEE DEE FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "ALTMAR",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-841-9003",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "10377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "759794",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4223789",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEE DEE HOME MED SUPPLY AND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dillon, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.