Vincents Drug Store and Soda Fountain

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9712 Issued in SC

Legal business name

VINCENTS DRUG STORE AND SODA FOUNTAIN

Doing business as

Vincents Drug Store

Practice address

110 Planted Row Lane
Johns Island, SC 29455

Phone

(843) 243-0007

Fax

(843) 243-0039

NPI assigned

Oct 20, 2006

Last updated

Feb 21, 2017By 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

Susan Cain, BS

Title

President

Phone

(888) 479-2000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• VINCENTS DRUG STORE Doing business as

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1265515795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 GARDNERS CIR # 122",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294555467",
            "telephone_number": "843-243-0007",
            "fax_number": "843-243-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PLANTED ROW LANE",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "29455",
            "telephone_number": "843-243-0007",
            "fax_number": "843-243-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENTS DRUG STORE AND SODA FOUNTAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "CAIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-479-2000",
        "authorized_official_credential": "BS"
    },
    "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": "9712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2092739",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782460",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VINCENTS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Johns Island, SC
• Providers in Johns Island, 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 Feb 21, 2017; 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.