Organization · Type 2 NPI

Berkeley Home Pharmacy LLC

Community/Retail Pharmacy · Moncks Corner, SC

NPI number 1508223645 Active

Practice location

1008 Old Highway 52 Ste G
Moncks Corner, SC 29461-3011

Fax (843) 899-4702

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	16354 (SC)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

3 other providers at this address

Other community/retail pharmacy providers in Moncks Corner

See all in Moncks Corner →

NPI record

NPI: 1508223645
Entity type: Organization (Type 2)
Issued: Jan 20, 2016
Last updated: Jun 10, 2025
Status: Active

Other names

<unavail>
Berkeley Home Pharmacy · doing business as
Berkeley Home Pharmacy · doing business as

Authorized official

Ted Tristan Nussbaum, RPH
Owner/pharmacist
(843) 899-4700

Verify this record

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.

Is this your record? How to update it.

About NPI 1508223645

Berkeley Home Pharmacy LLC's National Provider Identifier is 1508223645, issued on Jan 20, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Moncks Corner, SC. The record was last updated on Jun 10, 2025.