Ridgeland Drug Company Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PY 10704 Issued in SC

Legal business name

RIDGELAND DRUG COMPANY INC

Doing business as

Coastal Apothecary

Practice address

149 Riverwalk Blvd Ste 1
Ridgeland, SC 29936-8191

Phone

(843) 645-0800

Fax

(843) 645-0801

NPI assigned

Nov 13, 2009

Organization subpart

No

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

Authorized official

Name

Paige Couper

Title

President

Phone

(843) 645-0800

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Coastal Apothecary Doing business as

Locations

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1841527785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 RIVERWALK BLVD",
            "address_2": "SUITE 18, BOX 191",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299368190",
            "telephone_number": "843-645-0800",
            "fax_number": "843-645-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 RIVERWALK BLVD STE 1",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299368191",
            "telephone_number": "843-645-0800",
            "fax_number": "843-645-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGELAND DRUG COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "COUPER",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-645-0800"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "SC",
            "license": "PY 10704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4229351",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Starling Speed Ray III, DMD
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• Kristen Reeves
• Jada Marie Reilley, LMSW
• Ridgeland Dialysis LLC (Ridgeland Dialysis)
• Ridgeland Eye Associates LLC
• Ridgeland NC LLC (Ridgeland NC)
• Ridgeland Nursing Center Inc
• Ridgeland Physical Therapy, Inc.
• Ridgeland Smiles

• Compounding Pharmacy in Ridgeland, SC
• Providers in Ridgeland, 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 Jul 13, 2010; 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.