NPIMap

Organization Active NPI

Clemson University

Doing business as Redfern Health Center Pharmacy

  • Community/Retail Pharmacy
  • Clemson, SC
National Provider Identifier
1376669184
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1715 Issued in SC
Legal business name
CLEMSON UNIVERSITY
Doing business as
Redfern Health Center Pharmacy
Practice address
735 McMillan Rd
Clemson University
Clemson, SC 29634-0001
Phone
(864) 656-3562
Fax
(864) 656-2500
NPI assigned
Mar 22, 2007
Last updated
Feb 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Lesslie Pekarek, MDNPI 1912102013
Title
Avp of Student Health and Wellness
Phone
(864) 656-3565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X 1715 SC Primary

Addresses

Primary practice location

735 McMillan Rd
Clemson University
Clemson, SC 29634-0001

Mailing address

PO Box 344054
Clemson University
Clemson, SC 29634-0001
Phone (864) 656-3562

Other identifiers 2

IdentifierTypeStateIssuer
717152MedicaidSC
2089100OtherPK

Other names 1

  • Redfern Health Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clemson Univ Fire and EMS8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1376669184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344054",
            "address_2": "CLEMSON UNIVERSITY",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296340001",
            "telephone_number": "864-656-3562",
            "fax_number": "864-656-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 MCMILLAN RD",
            "address_2": "CLEMSON UNIVERSITY",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296340001",
            "telephone_number": "864-656-3562",
            "fax_number": "864-656-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "PEKAREK",
        "authorized_official_first_name": "LESSLIE",
        "authorized_official_title_or_position": "AVP OF STUDENT HEALTH AND WELLNESS",
        "authorized_official_telephone_number": "864-656-3565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "1715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "717152",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2089100",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redfern Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.