Individual provider Active NPI

Lauren Debolt, PHARMD

  • Pharmacist
  • Columbia, SC
National Provider Identifier
1306046529
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19013 Issued in NC
Practice address
WJBD Veterans Affairs Medical Center, Pharmacy #119
6439 Garners Ferry Rd.
Columbia, SC 29209-1639
Phone
(803) 776-4000
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19013 NC Primary

Addresses

Primary practice location

WJBD Veterans Affairs Medical Center, Pharmacy #119
6439 Garners Ferry Rd.
Columbia, SC 29209-1639

Mailing address

1100 Pulaski St
Apt #825
Columbia, SC 29201-3644

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

State licenses

LicenseStateTypeSpecialty
19013NCMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1306046529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PULASKI ST",
            "address_2": "APT #825",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WJBD VETERANS AFFAIRS MEDICAL CENTER, PHARMACY #119",
            "address_2": "6439 GARNERS FERRY RD.",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091639",
            "telephone_number": "803-776-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOLT",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.