Individual provider Active NPI

Glenn Dowdy, RPH

  • Pharmacist
  • Bennettsville, SC
National Provider Identifier
1942365523
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
006428 Issued in SC
Practice address
1114 Cottingham Blvd N
Bennettsville, SC 29512-2856
Phone
(843) 479-7101
Fax
(843) 479-3561
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 006428 SC Primary

Addresses

Primary practice location

1114 Cottingham Blvd N
Bennettsville, SC 29512-2856

Mailing address

1114 Cottingham Blvd N
Bennettsville, SC 29512-2856
Phone (843) 479-7101

Other identifiers 1

IdentifierTypeStateIssuer
DE2410MedicaidSC

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
006428SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Pharmacy Current Accepting new patients
Blue World, Inc. Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1942365523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 COTTINGHAM BLVD N",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122856",
            "telephone_number": "843-479-7101",
            "fax_number": "843-479-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 COTTINGHAM BLVD N",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122856",
            "telephone_number": "843-479-7101",
            "fax_number": "843-479-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWDY",
        "first_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "006428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2410",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennettsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.