Active NPI
Derek Puhalla, PHARMD
- Pharmacist
- Florence, SC
National Provider Identifier
1679020580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36830
- Practice address
- 2498 2ND Loop Rd
Florence, SC 29501-6162 - Phone
- (843) 317-1233
- NPI assigned
- Sep 8, 2016
- Last updated
- Sep 8, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36830 | SC | Primary |
Addresses
Primary practice location
2498 2ND Loop Rd
Florence, SC 29501-6162
Mailing address
2370 Freedom Blvd
Apt B2
Florence, SC 29505-6098
Phone (724) 650-2653
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36830 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1473292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1679020580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2370 FREEDOM BLVD",
"address_2": "APT B2",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295056098",
"telephone_number": "724-650-2653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2498 2ND LOOP RD",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295016162",
"telephone_number": "843-317-1233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUHALLA",
"first_name": "DEREK",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-08",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
- Pruitthealth Hospice, Inc. (PruittHealth Hospice - Pee Dee)
- Psychology Associates PA
- Publix Super Markets Inc (Publix Pharmacy #2144)
- Eric Conrad Puckett, RPH
- Kevin J. Pugh, MD
- Michael Pullmann, OTR/L
- Elizabeth Rushali Pulukuri, PHARMD
- Lauren Agnes Punter, M.D.
- Pure Life Chiropractic, P.C.
- Chiquita Jacquelle Purvis
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.