Individual provider Active NPI

Lisa L Largen, RPH

  • Pharmacist
  • Fort Mill, SC
National Provider Identifier
1659707974
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7901 Issued in SC
Practice address
1741 Gold Hill Rd Ste 106
Fort Mill, SC 29708-8204
Phone
(803) 547-6100
Fax
(803) 547-7720
NPI assigned
Sep 18, 2013
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7901 SC Primary

Addresses

Primary practice location

1741 Gold Hill Rd Ste 106
Fort Mill, SC 29708-8204

Mailing address

1741 Gold Hill Rd Ste 106
Fort Mill, SC 29708-8204
Phone (803) 547-6100

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
7901SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Om Sai RX LLC. CurrentSince May 19, 2024 Accepting new patients

Locations

1741 Gold Hill Rd
Ste 106
Fort Mill, SC 29708
Phone (803) 547-6100

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, 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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1659707974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 GOLD HILL RD STE 106",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088204",
            "telephone_number": "803-547-6100",
            "fax_number": "803-547-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 GOLD HILL RD STE 106",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088204",
            "telephone_number": "803-547-6100",
            "fax_number": "803-547-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGEN",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "7901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 19, 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.