Active NPI
Harleyville Drug LLC
Doing business as Harleyville Drug
- Community/Retail Pharmacy
- Harleyville, SC
National Provider Identifier
1346760592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 17297
- Legal business name
- HARLEYVILLE DRUG LLC
- Doing business as
- Harleyville Drug
- Practice address
- 108 W Main St
Harleyville, SC 29448-3700 - Phone
- (843) 462-7646
- Fax
- (843) 462-7646
- NPI assigned
- Jun 20, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marla Westbury
- Title
- Owner
- Phone
- (843) 563-1010
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 17297 | SC | Primary |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
108 W Main St
Harleyville, SC 29448-3700
Mailing address
701 N Parler Ave
Saint George, SC 29477-2233
Phone (843) 563-9384
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2171907 | Other | PK | |
| 717297 | Medicaid | SC |
Other names 1
- Harleyville Drug
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191028002184 | SC | Part B Supplier - Pharmacy | 3779815543 | Practice locations: Harleyville, SC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2184677 | Harleyville Drug, LLC | Certificate of waiver | May 21, 2028 |
National Provider Directory
National Provider DirectoryLocations
701 N Parler Ave
Saint George, SC 29477
Phone (843) 462-7646
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Saint George, SC
- NPI 1255486445
-
- Pharmacist
- Saint George, SC
- NPI 1033467923
-
- Pharmacist
- Orangeburg, SC
- NPI 1801341490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531958400000",
"number": "1346760592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 N PARLER AVE",
"city": "SAINT GEORGE",
"state": "SC",
"postal_code": "294772233",
"telephone_number": "843-563-9384",
"fax_number": "843-563-9386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W MAIN ST",
"city": "HARLEYVILLE",
"state": "SC",
"postal_code": "294483700",
"telephone_number": "843-462-7646",
"fax_number": "843-462-7646"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HARLEYVILLE DRUG LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-06-20",
"last_updated": "2018-07-19",
"status": "A",
"authorized_official_last_name": "WESTBURY",
"authorized_official_first_name": "MARLA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "843-563-1010"
},
"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": "17297",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2171907",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "717297",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Harleyville Drug",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Harleyville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.