Individual provider Active NPI

Clarence Eugene Schiltz III, RPH, PHARMD, MSCR

  • Pharmacist
  • Moore, SC
National Provider Identifier
1235487117
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13695 Issued in SC
Practice address
5895 Reidville Rd
Moore, SC 29369-8409
Phone
(864) 486-6990
Fax
(864) 486-6996
NPI assigned
Aug 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13695 SC Primary

Addresses

Primary practice location

5895 Reidville Rd
Moore, SC 29369-8409

Mailing address

5895 Reidville Rd
Moore, SC 29369-8409
Phone (864) 486-6990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13695SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1235487117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5895 REIDVILLE RD",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293698409",
            "telephone_number": "864-486-6990",
            "fax_number": "864-486-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5895 REIDVILLE RD",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293698409",
            "telephone_number": "864-486-6990",
            "fax_number": "864-486-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILTZ",
        "first_name": "CLARENCE",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "RPH, PHARMD, MSCR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "13695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.