Organization · Type 2 NPI

South Carolina Department of Mental Health

Long Term Care Pharmacy · Columbia, SC

NPI number 1043365703 Active

Practice location

2200 Harden St.
Columbia, SC 29203-7107

Fax (803) 737-5436

Specialties and licenses

Taxonomy	Code	License
Nursing Facility/Intermediate Care Facility	313M00000X	50001783 (SC)
Skilled Nursing Facility	314000000X	50-001783 (SC)
Inpatient Hospice	315D00000X	50001783 (SC)
Nursing Facility Supplies (DME)	332BN1400X	50001783 (SC)
Pharmacy	333600000X	50001783 (SC)
Long Term Care Pharmacy Primary	3336L0003X	50001783 (SC)

Long Term Care Pharmacy: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

Other long term care pharmacy providers in Columbia

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NPI record

NPI: 1043365703
Entity type: Organization (Type 2)
Issued: Jan 24, 2007
Last updated: Oct 18, 2011
Status: Active
Subpart: Yes of South Carolina Department of Mental Health

Other names

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C.m.tucker,jr Nursing Care Center Pharmacy · other name

Authorized official

Kimberly Butterfly Rudd, MD
Director of Professional Services
(803) 737-5301

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043365703

South Carolina Department of Mental Health's National Provider Identifier is 1043365703, issued on Jan 24, 2007. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in Columbia, SC. The record was last updated on Oct 18, 2011.