Active NPI
Colie Fulmer
- Pharmacist
- Peak, SC
National Provider Identifier
1811454572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11522
- Practice address
- 22 River St
Peak, SC 29122 - Phone
- (803) 345-1707
- NPI assigned
- Feb 28, 2019
- Last updated
- Feb 28, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 11522 | SC | Primary |
Addresses
Primary practice location
22 River St
Peak, SC 29122
Mailing address
1908 Clark Rd
Little Mountain, SC 29075-8736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11522 | Other | SC | PHARMACY LIC. |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11522 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Pharmacy Inc | Current | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Peak, SC
- NPI 1922029644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551312000000",
"number": "1811454572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1908 CLARK RD",
"city": "LITTLE MOUNTAIN",
"state": "SC",
"postal_code": "290758736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 RIVER ST",
"city": "PEAK",
"state": "SC",
"postal_code": "29122",
"telephone_number": "803-345-1707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULMER",
"first_name": "COLIE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-28",
"last_updated": "2019-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "11522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LIC.",
"identifier": "11522",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peak, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.