Organization Active NPI

Delta of Charleston, Inc

  • Community/Retail Pharmacy
  • Charleston, SC
National Provider Identifier
1508008202
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DELTA OF CHARLESTON, INC
Practice address
346 E Bay St
Charleston, SC 29401-1551
Phone
(843) 937-0960
Fax
(843) 937-0960
NPI assigned
Mar 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Van Willis High
Title
Owner
Phone
(843) 761-5255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X SC Primary

Addresses

Primary practice location

346 E Bay St
Charleston, SC 29401-1551

Mailing address

402 E Main St
Moncks Corner, SC 29461-3616
Phone (843) 761-5255

Other names 1

  • Delta of Charleston, Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140520000757 SC Part B Supplier - Mass Immunization (Roster Biller Only) 8820211899 Practice locations: Charleston, 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
42D2182777Delta of Charleston, Inc346 East Bay Street, Charleston, SC 29401Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory

Locations

320 E Bay St
Ste A
Charleston, SC 29401

320 E Bay St
Charleston, SC 29401
Phone (843) 937-0960

346 E Bay St
Charleston, SC 29401
Phone (843) 937-0960

Practitioners & affiliated clinicians

Practitioners 2

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": "1238112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1508008202",
    "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": "843-761-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 E BAY ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011551",
            "telephone_number": "843-937-0960",
            "fax_number": "843-937-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA OF CHARLESTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-27",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "HIGH",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "WILLIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-761-5255"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta of Charleston, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.