Organization Active NPI

Presbyterian College

  • Pharmacotherapy Pharmacist
  • Clinton, SC
National Provider Identifier
1710273594
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
11110 Issued in SC
Legal business name
PRESBYTERIAN COLLEGE
Practice address
307 N Broad St
Clinton, SC 29325-2305
Phone
(864) 938-3900
NPI assigned
Jun 21, 2011
Organization subpart
Yes
Parent organization
PRESBYTERIAN COLLEGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Authorized official

Name
Dr. Richard E. Stull, PHD
Title
Dean
Phone
(864) 938-3901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1835P1200X 11110 SC Primary

Addresses

Primary practice location

307 N Broad St
Clinton, SC 29325-2305

Mailing address

307 N Broad St
Clinton, SC 29325-2305
Phone (864) 938-3900

Other names 1

  • School of Pharmacy; PCSP Diabetes Center; PCSP Wellness Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2018803Presbyterian College School of Pharmacy307 N Broad St, Clinton, SC 29325Certificate of waiverJan 13, 2027

National Provider Directory

National Provider Directory
Part of
Presbyterian College

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1710273594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N BROAD ST",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293252305",
            "telephone_number": "864-938-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N BROAD ST",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293252305",
            "telephone_number": "864-938-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN COLLEGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESBYTERIAN COLLEGE",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "STULL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DEAN",
        "authorized_official_telephone_number": "864-938-3901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "SC",
            "license": "11110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "School of Pharmacy; PCSP Diabetes Center; PCSP Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.