Polaris Jack, Inc.

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

POLARIS JACK, INC.

Doing business as

Pure Compounding

Practice address

3072 Dick Pond Rd Unit 2
Myrtle Beach, SC 29588-6954

Phone

(843) 293-7979

Fax

(843) 293-6499

NPI assigned

Aug 6, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Forrest Westley, PHARMDNPI 1740819309

Title

President

Phone

(843) 293-7979

Specialties & licenses 1

Addresses

Other names 1

• Pure Compounding Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Forrest Halsey Westley, PHARMD

  • Pharmacist
  • Myrtle Beach, SC
  • NPI 1740819309
  NPD Authorized official

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1740890433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3072 DICK POND RD UNIT 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886954",
            "telephone_number": "843-293-7979",
            "fax_number": "843-293-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3072 DICK POND RD UNIT 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295886954",
            "telephone_number": "843-293-7979",
            "fax_number": "843-293-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS JACK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "WESTLEY",
        "authorized_official_first_name": "FORREST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-293-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "forrest@pure-compounding.com",
            "affiliation": "N",
            "endpointDescription": "address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3072 Dick Pond Rd Unit 2",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295886954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pure Compounding",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christian Cole Plummer, DO
• Thomas Hamilton Plyler, FNP-C
• Damien Poet
• Lee Pohto, CCC-SLP
• Lyndsay Polanski
• Polaris Skin Diagnostics, LLC
• Polaya Anesthesia LLC
• Thomas Alan Polen, MD
• Vjekoslav Marko Polic, M.D.
• Jennifer Theresa Poling, RN

• Compounding Pharmacy in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Compounding Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.