Active NPI
Angela Walls Daniels
- Pharmacist
- Myrtle Beach, SC
National Provider Identifier
1932485935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10902
- Practice address
- 3735 Renee Dr
Myrtle Beach, SC 29579-4109 - Phone
- (843) 236-4296
- Fax
- (843) 236-4274
- NPI assigned
- Oct 24, 2011
- Last updated
- Oct 24, 2011
- Sex
- Female
- 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 | 10902 | SC | Primary |
Addresses
Primary practice location
3735 Renee Dr
Myrtle Beach, SC 29579-4109
Mailing address
3735 Renee Dr
Myrtle Beach, SC 29579-4109
Phone (843) 236-4296
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10902 | SC | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kroger Co | Past | Accepting new patients | |
| Kroger Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1932485935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3735 RENEE DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295794109",
"telephone_number": "843-236-4296",
"fax_number": "843-236-4274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3735 RENEE DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295794109",
"telephone_number": "843-236-4296",
"fax_number": "843-236-4274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "ANGELA",
"middle_name": "WALLS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "10902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.