Tidewater Pharmacy & Compounding

LBN: Tidewater Pharmacy & Medical Supply Llc
Tidewater Pharmacy & Compounding is an health care organization with primary practice located at 421 Johnnie Dodds Blvd Ste 100, Mount Pleasant SC 29464-3052. The organization recently has only one registered license in Suppliers / Specialty Pharmacy, which is considered as the primary health care specialty. Tidewater Pharmacy & Medical Supply Llc can be contacted via phone (843) 375-6310, or through Straughan, Chad Louis via phone (842) 375-6310.

Contact Information

Primary practice address
421 Johnnie Dodds Blvd Ste 100 Mount Pleasant SC 29464-3052
Phone: (843) 375-6310
Fax: (843) 375-6311
Website:
Map and Directions
Authorized official contact:
Name: Straughan, Chad Louis PHARMD
Phone: (842) 375-6310

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Specialty Pharmacy 3336S0011X 15890 South Carolina

Profile Details

NPI number 1417316548
LBN Legal business name Tidewater Pharmacy & Medical Supply Llc
DBA Doing business as Tidewater Pharmacy & Compounding
Authorized official Straughan, Chad Louis PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 17th, 2016
Last updated Feb 17th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417316548 NPPES
South Carolina MEDICAID 715890

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