Individual provider Active NPI

Zachary William Mullin, PHARM D.

  • Pharmacist
  • Charleston, SC
National Provider Identifier
1629543541
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
37725 Issued in SC
Practice address
776 Daniel Ellis Dr Ste 2C
Charleston, SC 29412-3096
Phone
(843) 795-9554
Fax
(843) 795-2660
NPI assigned
Oct 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 37725 SC Primary

Addresses

Primary practice location

776 Daniel Ellis Dr Ste 2C
Charleston, SC 29412-3096

Mailing address

3306 Sweet PL
Charleston, SC 29492-2845
Phone (507) 304-5351

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
37725SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plantation Pharmacy at Ellis Oaks Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1629543541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 SWEET PL",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294922845",
            "telephone_number": "507-304-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 DANIEL ELLIS DR STE 2C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294123096",
            "telephone_number": "843-795-9554",
            "fax_number": "843-795-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "ZACHARY",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-07",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "37725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 17, 2020; 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.