Organization Active NPI

Redec Pharmacy

  • Community/Retail Pharmacy
  • Fort Mill, SC
National Provider Identifier
1619485992
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17732 Issued in SC
Legal business name
REDEC PHARMACY
Practice address
200 N Dobys Bridge Rd Ste 124
Fort Mill, SC 29715-2084
Phone
(803) 802-3915
Fax
(803) 802-3915
NPI assigned
Jan 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Hewis BartelsNPI 1992043343
Title
Pharmacist in Charge
Phone
(478) 919-8881

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 17732 SC Primary

Addresses

Primary practice location

200 N Dobys Bridge Rd Ste 124
Fort Mill, SC 29715-2084

Mailing address

200 N Dobys Bridge Rd Ste 124
Fort Mill, SC 29715-2084
Phone (803) 802-3001

Other identifiers 2

IdentifierTypeStateIssuer
717732MedicaidSC
2175595OtherPK

Other names 1

  • REDEC PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180522000878 SC Part B Supplier - Pharmacy 6002171097 Practice locations: Fort Mill, SC

National Provider Directory

National Provider Directory

Locations

200 N Dobys Bridge Rd
Ste 124
Fort Mill, SC 29715
Phone (803) 802-3001

Practitioners & affiliated clinicians

Practitioners 1

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": "1516406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1619485992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N DOBYS BRIDGE RD STE 124",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297152084",
            "telephone_number": "803-802-3001",
            "fax_number": "803-802-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N DOBYS BRIDGE RD STE 124",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297152084",
            "telephone_number": "803-802-3915",
            "fax_number": "803-802-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDEC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-20",
        "last_updated": "2025-09-19",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "BARTELS",
        "authorized_official_first_name": "HEWIS",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "478-919-8881"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "17732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "717732",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175595",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REDEC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REDEC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.