Organization Active NPI

Blue World, Inc.

Doing business as medcare pharmacy

  • Community/Retail Pharmacy
  • Clover, SC
National Provider Identifier
1649518036
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BLUE WORLD, INC.
Doing business as
medcare pharmacy
Practice address
723 Bethel St
Clover, SC 29710-1157
Phone
(843) 676-5115
NPI assigned
Jan 20, 2013
Last updated
Jan 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Authorized official

Name
Mr. Robert Glenn Dowdy
Title
Owner
Phone
(843) 676-5115

Specialties & licenses 1

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

Addresses

Primary practice location

723 Bethel St
Clover, SC 29710-1157

Mailing address

1114 Cottingham Blvd N
Suite B
Bennettsville, SC 29512-2856
Phone (843) 676-5115

Other names 1

  • medcare pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191217002065 SC Part B Supplier - Mass Immunization (Roster Biller Only) 0244664621 Practice locations: Clover, SC

National Provider Directory

National Provider Directory

Locations

1114B Cottingham Blvd N
Bennettsville, SC 29512

723 Bethel St
Clover, SC 29710
Phone (803) 222-6060

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358726400000",
    "number": "1649518036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 COTTINGHAM BLVD N",
            "address_2": "SUITE B",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122856",
            "telephone_number": "843-676-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 BETHEL ST",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297101157",
            "telephone_number": "843-676-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WORLD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-20",
        "last_updated": "2013-01-21",
        "status": "A",
        "authorized_official_last_name": "DOWDY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-676-5115",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "medcare pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clover, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.