Robert Derek Hitchcock, PHARMD – Pharmacist

Key facts

NPI: 1487969150
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 12777 (SC)
Practice address: 5900 N Kings Hwy Ste C
Myrtle Beach, SC 29577-2326
Phone: (843) 712-1703
NPI assigned: Aug 18, 2010
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Specialty Pharmacy Myrtle Beach LLC Community/Retail Pharmacy · Myrtle Beach, SC · NPI 1033423348

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Pharmacy

State licenses

License	State	Type	Specialty
12777	SC	MD	Social Worker

Practice roles

Organization	Specialty	Status	New patients
Specialty Pharmacy Myrtle Beach LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	12777	SC	Yes

Addresses

Primary practice location

5900 N Kings Hwy Ste C
Myrtle Beach, SC 29577-2326

Mailing address

5900 N Kings Hwy Ste C
Myrtle Beach, SC 29577-2326
Phone (843) 712-1703

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 18, 2010.

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1487969150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 N KINGS HWY STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772326",
            "telephone_number": "843-712-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N KINGS HWY STE C",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295772326",
            "telephone_number": "843-712-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHCOCK",
        "first_name": "ROBERT",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "12777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

All providers in Myrtle Beach, SC · Pharmacist in South Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.