Delta of Hollywood LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

16077 Issued in SC

Legal business name

DELTA OF HOLLYWOOD LLC

Doing business as

Delta Pharmacy & Medical Supply

Practice address

6251 Highway 162
Hollywood, SC 29449-5782

Phone

(843) 564-5720

Fax

(843) 899-4970

NPI assigned

Jul 28, 2015

Last updated

Apr 17, 2025By 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

Sherry Parsons

Title

Manager

Phone

(843) 761-5255

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Delta Pharmacy & Medical Supply Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1356726798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613616",
            "telephone_number": "843-761-5255",
            "fax_number": "843-899-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6251 HIGHWAY 162",
            "city": "HOLLYWOOD",
            "state": "SC",
            "postal_code": "294495782",
            "telephone_number": "843-564-5720",
            "fax_number": "843-899-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA OF HOLLYWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "PARSONS",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-761-5255"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "16077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Pharmacy & Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Iesha Renee Campbell
• Sharon Coe, RPH
• Tempest Teonnia Council
• Mary Elizabeth Creed, APRN, FNP-C
• Marsha Gay Delavan, PA C
• Terri Donofrio, RPH
• Polly Jones Epstein, LISW-CP
• Fetter Health Care Network Inc (Fetter Health Care Network-Hollywood Site)
• Fetter Health Care Network Inc (Minnie Hughes Elementary School)
• Fetter Health Care Network Inc (Fetter Health Care Network -White Camp Mirgrant Location)

• Community/Retail Pharmacy in Hollywood, SC
• Providers in Hollywood, 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 Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.