Active NPI
Caleb A Fackler, PHARMD, MBA
- Pharmacist
- North Charleston, SC
National Provider Identifier
1922528561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 37128
- Practice address
- 4920 Centre Pointe Dr
North Charleston, SC 29418-6927 - Phone
- (843) 740-5484
- Fax
- (843) 740-6766
- NPI assigned
- Jun 25, 2017
- 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 | 37128 | SC | Primary |
Addresses
Primary practice location
4920 Centre Pointe Dr
North Charleston, SC 29418-6927
Mailing address
4920 Centre Pointe Dr
North Charleston, SC 29418-6927
Phone (843) 740-5484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37128 | Other | SC | STATE LICENSE |
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
- Credentials
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37128 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656115200000",
"number": "1922528561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 CENTRE POINTE DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294186927",
"telephone_number": "843-740-5484",
"fax_number": "843-740-6766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 CENTRE POINTE DR",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294186927",
"telephone_number": "843-740-5484",
"fax_number": "843-740-6766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FACKLER",
"first_name": "CALEB",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHARMD, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-25",
"last_updated": "2022-06-25",
"certification_date": "2021-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "37128",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "37128",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
- Extended Care Respiratory Partners LLC
- Extended Family Home Care Services
- Eyemart Express LLC
- Kristen Ezsol
- Jenna Fabrizio, LCSW
- Christopher Michael Fagerstrom, DC
- Matthew David Falter
- Family Dental Health of Oakbrook
- Family Laser Dental of North Charleston
- Family Laser Dental of North Charleston LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.