Active NPI
Jerry B Griggs
- Pharmacist
- Hartsville, SC
National Provider Identifier
1528318920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4042
- Practice address
- 2310 W Bobo Newsom Hwy
Hartsville, SC 29550 - Phone
- (843) 333-2419
- NPI assigned
- Sep 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4042 | SC | Primary |
Addresses
Primary practice location
2310 W Bobo Newsom Hwy
Hartsville, SC 29550
Mailing address
3861 N Center Rd
Hartsville, SC 29550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4042 | SC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| South Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1528318920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3861 N CENTER RD",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "29550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 W BOBO NEWSOM HWY",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "29550",
"telephone_number": "843-333-2419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGGS",
"first_name": "JERRY",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-12",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "4042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartsville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.