Organization Active NPI

Harleyville Drug LLC

Doing business as Harleyville Drug

  • Community/Retail Pharmacy
  • Harleyville, SC
National Provider Identifier
1346760592
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17297 Issued in SC
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

Updated by the provider on Jul 19, 2018

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2171907OtherPK
717297MedicaidSC

Other names 1

  • Harleyville Drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191028002184 SC Part B Supplier - Pharmacy 3779815543 Practice locations: Harleyville, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2184677Harleyville Drug, LLC108 West Main Street, Harleyville, SC 29448Certificate of waiverMay 21, 2028

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.