NPIMap

Organization Active NPI

Gustafsons Apothecary LLC

  • Community/Retail Pharmacy
  • Columbia, SC
National Provider Identifier
1558756072
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
15837 Issued in SC
Legal business name
GUSTAFSONS APOTHECARY LLC
Doing business as
Landy's Pharmacy
Practice address
835 Sparkleberry Lane
Columbia, SC 29229-2922
Phone
(803) 567-3107
Fax
(803) 736-6228
NPI assigned
Apr 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Yalander GambleNPI 1316283047
Title
Owner/Pharmacist
Phone
(803) 738-5706

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 15837 SC Primary

Addresses

Primary practice location

835 Sparkleberry Lane
Columbia, SC 29229-2922

Mailing address

835 Sparkleberry Lane
Columbia, SC 29229
Phone (803) 567-3107

Other identifiers 2

IdentifierTypeStateIssuer
2150419OtherPK
715837MedicaidSC

Other names 1

  • Landy's Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

110A Clemson Rd
Columbia, SC 29229
Phone (803) 567-3107

Practitioners & affiliated clinicians

Practitioners 3

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": "1427846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1558756072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SPARKLEBERRY LANE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29229",
            "telephone_number": "803-567-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SPARKLEBERRY LANE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292292922",
            "telephone_number": "803-567-3107",
            "fax_number": "803-736-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAFSONS APOTHECARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-01",
        "last_updated": "2021-02-23",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "YALANDER",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "803-738-5706"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "15837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150419",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "715837",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landy's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Landy's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.