Charleston Clinical & Health Services, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

001807 Issued in SC

Legal business name

CHARLESTON CLINICAL & HEALTH SERVICES, INC.

Doing business as

Medical Plaza Pharmacy

Practice address

9301 Medical Plaza Dr
North Charleston, SC 29406-9103

Phone

(843) 553-7121

Fax

(843) 553-5800

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. J. L. Brueggeman, PHARM. D.

Title

Director

Phone

(843) 553-7121

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Medical Plaza Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1841373123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 MEDICAL PLAZA DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069103",
            "telephone_number": "843-553-7121",
            "fax_number": "843-553-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 MEDICAL PLAZA DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069103",
            "telephone_number": "843-553-7121",
            "fax_number": "843-553-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON CLINICAL & HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUEGGEMAN",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-553-7121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "1807",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "001807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "42-09892",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718076",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Plaza Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.