Ridge LTC Pharmacy, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

17919 Issued in SC

Legal business name

RIDGE LTC PHARMACY, LLC

Practice address

4079 Augusta Hwy Ste a
Gilbert, SC 29054

Phone

(803) 756-4175

Fax

(803) 756-4178

NPI assigned

Apr 30, 2018

Organization subpart

No

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

Authorized official

Name

Bevin W. MettsNPI 1558612564

Title

Owner/Pharmacist

Phone

(803) 756-4175

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

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

• Bevin Whitman Metts

  • Pharmacist
  • Gilbert, SC
  • NPI 1558612564
  NPD Authorized official
• Denise G. Derrick

  • Pharmacist
  • Gilbert, SC
  • NPI 1376829374
  NPD

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1992293476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2407",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290700407",
            "telephone_number": "803-756-4175",
            "fax_number": "803-756-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4079 AUGUSTA HWY STE A",
            "city": "GILBERT",
            "state": "SC",
            "postal_code": "29054",
            "telephone_number": "803-756-4175",
            "fax_number": "803-756-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE LTC PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "METTS",
        "authorized_official_first_name": "BEVIN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "803-756-4175"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "SC",
            "license": "17919",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Gilbert, SC
• Long Term Care Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.