K-Tuck L L C

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

50005766 Issued in SC

Legal business name

K-TUCK L L C

Doing business as

central pharmacy

Practice address

303 N Main St
Lake View, SC 29563

Phone

(843) 759-2800

Fax

(843) 759-9974

NPI assigned

Jun 1, 2007

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Keith D Tucker, RPH

Title

Pharmacist

Phone

(843) 759-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• central pharmacy Doing business as

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1932301959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1248",
            "city": "LAKE VIEW",
            "state": "SC",
            "postal_code": "295631248",
            "telephone_number": "843-759-2800",
            "fax_number": "843-759-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N MAIN ST",
            "city": "LAKE VIEW",
            "state": "SC",
            "postal_code": "29563",
            "telephone_number": "843-759-2800",
            "fax_number": "843-759-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K-TUCK L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "843-759-2800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "50005766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1265",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "central pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Lake View, SC
• Providers in Lake View, 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 Jun 17, 2008; 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.