Pawleys Island Pharm at Litchfield

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

7379930001 Issued in SC

Legal business name

PAWLEYS ISLAND PHARM AT LITCHFIELD

Practice address

115 Willbrook Blvd Unit a
Pawleys Island, SC 29585-6542

Phone

(843) 314-0498

Fax

(843) 314-0580

NPI assigned

Apr 5, 2016

Organization subpart

No

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

Authorized official

Name

Glenn A Cox, RPH

Title

Owner

Phone

(843) 314-0498

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• pawleys island pharmacy of litchfield Former legal business name

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1841653938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WILLBROOK BLVD UNIT A",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856542",
            "telephone_number": "843-314-0498",
            "fax_number": "843-314-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WILLBROOK BLVD UNIT A",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295856542",
            "telephone_number": "843-314-0498",
            "fax_number": "843-314-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWLEYS ISLAND PHARM AT LITCHFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-314-0498",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "7379930001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "715334",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B PROVIDER",
            "identifier": "7379930001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pawleys island pharmacy of litchfield",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Patricia R. Grant, MD PA
• Pawleys Internal Medicine, P.C.
• Pawleys Island Compounding Pharmacy LLC
• Pawleys Island Compounding Pharmacy LLC
• Pawleys Island Pediatric Dentistry
• Pawleys Island Pharmacy LLC (Pawleys Island Pharmacy)
• Pawleys Island Pharmacy of Litchfield LLC (Pawleys Island Pharmacy of Litchfield)
• Pawleys Service Partners LLC (Home Care Assistance of the Grand Strand)
• Steven J Petersen Jr., MD
• Richard Andrew Philipp II, MD

• Durable Medical Equipment & Medical Supplies in Pawley's Island, SC
• Providers in Pawley's Island, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.