MEDICAL CENTER INC. OF PICKENS (NPI# 1134170764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134170764 |
| Entity Type | Organization |
| Organization Name | MEDICAL CENTER INC. OF PICKENS |
| Other Organization Name | CUSTOM-MED COMPOUNDING PHARMACY |
| Practice Address |
838 Powdersville Rd Suite D Easley SC 29642-3703 |
| Practice Telephone | 8648552323 |
| Practice Fax Number | 8648552606 |
| Mailing Telephone | 8648552323 |
| Mailing Fax Number | 8648552606 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN E. HOLLAND (PRESIDENT) |
| Authorized Official Telephone | 8648552323 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 608612 | 05 | |
| SC | 708614 | 05 |
| Other Name | Type Code |
|---|---|
| CUSTOM-MED COMPOUNDING PHARMACY | Doing Business As Name - Organization |
| Street Address |
838 POWDERSVILLE RD SUITE D |
| City | EASLEY |
| State | SC |
| Zip Code | 29642-3703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578065165 | Elevate Audiology LLC | Audiologist | 838 Powdersville Rd, Easley, SC 29642-3703 | 2018-02-28 |
| 1528572484 | Greenville Proaxis Therapy LLC | Durable Medical Equipment & Medical Supplies | 838 Powdersville Rd, Easley, SC 29642-3703 | 2017-11-29 |
| 1710413620 | Thrive Chiropractic of Easley LLC | Chiropractor | 838 Powdersville Rd, Suite E, Easley, SC 29642-3703 | 2017-05-11 |
| 1275908352 | Clemson Sports Medicine and Rehabilitation Inc | Clinic/Center | 838 Powdersville Rd, Suite T, Easley, SC 29642-3703 | 2015-12-01 |
| 1548595648 | Jaime Fisher Browning | Chiropractor | 838 Powdersville Rd, Suite R, Easley, SC 29642-3703 | 2009-10-07 |
| 1871783845 | Livingwell Integrative Healthcare | Clinic/Center | 838 Powdersville Rd, Suite G, Easley, SC 29642-3703 | 2007-07-26 |
| 1679787618 | The Upstate Clinic of Specific Chir | Chiropractor | 838 Powdersville Rd, Suite R, Easley, SC 29642-3703 | 2007-05-09 |
| 1932295912 | Cheryl Willis Middleton | Physician Assistant | 838 Powdersville Rd, Suite G, Easley, SC 29642-3703 | 2006-10-05 |
| 1366548125 | David A. Waters | Dentist | 838 Powdersville Rd, Suite E, Easley, SC 29642-3703 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316911 | Marlesia Hall | Licensed Practical Nurse | 106 Teal Dr, Easley, SC 29642 | 2020-11-06 |
| 1437648904 | Onsite Healthcare and Wellness LLC | Nurse Practitioner | 217 Sheffield Ct, Easley, SC 29642 | 2018-05-09 |
| 1477073476 | Aubre True | Specialist/Technologist | 124 Century Oaks Dr, Easley, SC 29642 | 2017-06-21 |
| 1912439944 | First Physical Therapy, LLC | Clinic/Center | 3613 Sc 153, Suite 200, Powdersville, SC 29642 | 2017-03-29 |
| 1801146485 | Sara Michele Calvert | Pharmacist | 1063 South Pendleton Street, Easley, SC 29642 | 2012-09-11 |
| 1023365251 | Heather Lilley | Pharmacist | 5251 Calhoun Memorial Hwy, Easley, SC 29642 | 2012-08-07 |
| 1942590088 | Mallorie Bryan Costner | Speech-Language Pathologist | 507 Huntington Road, Easley, SC 29642 | 2011-04-11 |
| 1225352339 | Jon Lawrence Rhoden | Pharmacist | 320 Watson Road, Easley, SC 29642 | 2010-03-18 |
| 1386865350 | Gordon David Dannelly | Dentist | 701 Brushy Creek Road, Easley, SC 29642 | 2007-05-01 |
| 1538280755 | Michelle Leigh Tucker | Obstetrics & Gynecology | 1351 Crestview Road, Easley, SC 29642 | 2007-04-03 |
| Find all providers in zip 29642 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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 health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053788638 | Rpvr Corporation | Pharmacy | 121 Fleetwood Dr, Easley, SC 29640-2019 | 2015-08-30 |
| 1902900707 | South Carolina Cvs Pharmacy LLC | Pharmacy | 1063 S Pendleton St, Easley, SC 29642-1040 | 2006-09-12 |
| 1255982567 | Oracle Pharmacy | Pharmacy | 1040 S Pendleton St Ste C, Easley, SC 29642-1047 | 2019-09-27 |
| 1588002497 | Ingles Markets Inc | Pharmacy | 5251 Calhoun Memorial Hwy, Easley, SC 29642 | 2013-06-13 |
| 1346412939 | Ingles Markets Inc | Pharmacy | 410 Pelzer Hwy, Easley, SC 29642-2106 | 2008-03-24 |
| 1932118411 | Powdersville Pharmacy, Pa | Pharmacy | 10701 Anderson Rd, Easley, SC 29642-9309 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720535 | Detyens Medical Center | Pharmacy | 1670 Drydock Avenue, Building 10, Suite A, North Charleston, SC 29405 | 2020-11-03 |
| 1053918458 | Johns Island Pharmacy LLC | Pharmacy | 3133 Maybank Hwy, Johns Island, SC 29455-4838 | 2020-10-08 |
| 1821695735 | Msm Rx LLC | Pharmacy | 6323b N Main St, Columbia, SC 29203-4733 | 2020-10-04 |
| 1235743295 | Kp and Rd LLC | Pharmacy | 721 N Greenwood Avenue, Ware Shoals, SC 29692 | 2020-09-06 |
| 1265045322 | Ptvp | Pharmacy | 8007 Warren H Abernathy Hwy, Spartanburg, SC 29301-2449 | 2020-08-28 |
| 1841801669 | Christmas Pharmacy LLC | Pharmacy | 1229 Alice Dr # B, Sumter, SC 29150-1970 | 2020-08-14 |
| 1639796022 | Wall Drugs of Pamplico, Inc. | Pharmacy | 616 S. Walnut Street, Pamplico, SC 29583 | 2020-07-01 |
| 1851913974 | Ebenezer Health Investors Inc | Pharmacy | 3217 Devine St, Columbia, SC 29205-1847 | 2020-05-12 |
| 1457971541 | Nephron Pharmacy LLC | Pharmacy | 4500 12th Street Ext Ste B, West Columbia, SC 29172-3025 | 2020-04-20 |
| 1770112849 | Fountain Inn Rx LLC | Pharmacy | 106 S Weston St, Fountain Inn, SC 29644-1940 | 2020-04-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MEDICAL CENTER INC. OF PICKENS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.