Park Circle Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PARK CIRCLE PHARMACY, LLC

Practice address

4412 Spruill Ave Ste C
North Charleston, SC 29405-4787

Phone

(843) 806-1299

NPI assigned

Jun 14, 2022

Organization subpart

No

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

Authorized official

Name

Michael Wise

Title

Partner

Phone

(843) 806-1299

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shad J Sutherland, RPH

  • Pharmacist
  • North Charleston, SC
  • NPI 1336739663
  NPD

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1972233807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 NORVIEW CIR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073713",
            "telephone_number": "843-754-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 SPRUILL AVE STE C",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054787",
            "telephone_number": "843-806-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CIRCLE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "843-806-1299"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7Z1200",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirsten L. Paris, PA-C
• Samuel Keith Parish, M.D.
• Park Circle Chiropractic Center LLC
• Park Circle Counseling
• Park Circle Orthodontics, LLC
• Park Circle Vision LLC
• Parkereyesllc
• Parkereyesllc
• Britney Suzanne Annis Parks, LISW, CP.
• Timothy Parks, PH.D.

• Community/Retail Pharmacy in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.