LAKE WYLIE HEALTH INVESTORS INC (NPI# 1336424167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336424167 |
| Entity Type | Organization |
| Organization Name | LAKE WYLIE HEALTH INVESTORS INC |
| Other Organization Name | LAKE WYLIE PHARMACY |
| Practice Address |
221 Latitude Ln Ste 109 Lake Wylie SC 29710-8117 |
| Mailing Address |
Po Box 5343 Lake Wylie SC 29710-5004 |
| Practice Telephone | 8038312044 |
| Practice Fax Number | 8039398489 |
| Mailing Telephone | 8038312044 |
| Mailing Fax Number | 8039398389 |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2012-12-20 |
| Authorized Official Name | KYLE MCHUGH (PRESIDENT) |
| Authorized Official Telephone | 8032409882 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
13665 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4230479 | 01 |
| Other Name | Type Code |
|---|---|
| Lake Wylie Pharmacy | Doing Business As Name - Organization |
| Street Address |
221 LATITUDE LN STE 109 |
| City | LAKE WYLIE |
| State | SC |
| Zip Code | 29710-8117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750912325 | Courtney Elizabeth Allen | Pharmacist | 221 Latitude Ln Ste 109, Lake Wylie, SC 29710-8117 | 2020-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728243 | Jessica Pampalone | Pharmacist | 175 Sc-274, Lake Wylie, SC 29710 | 2018-08-02 |
| 1932628344 | Andrew Thomas Sullivan | Student in an Organized Health Care Education/Training Program | 106 Mccall Street, Clover, SC 29710 | 2017-09-18 |
| 1619423449 | Dental Professionals of South Carolina, P.C. | Dentist | 209 Latitude Lane, Clover, SC 29710 | 2016-08-31 |
| 1932538816 | Tara Mehta | Psychologist | 48 Fairway Rdg, Clover, SC 29710 | 2013-11-01 |
| 1710238795 | Hong N Mitchell | Pharmacist | 158 Hwy. 274, Lake Wylie, SC 29710 | 2012-10-01 |
| 1790948602 | Barbara Ellen Anslow-myers | Speech-Language Pathologist | 530 Little Cove Lane, Lake Wylie, SC 29710 | 2008-07-10 |
| 1720200884 | Lake Wylie | Assisted Living Facility | 4877 Charlotte Highway, Lake Wylie, SC 29710 | 2007-05-02 |
| 1790804581 | Phillip Russell Sanford | Pharmacist | 3272 Wicklow Ln, Clover, SC 29710 | 2007-03-29 |
| 1124158472 | Thomas N Stall Sr. | Dentist | 1100 Village Harbor Dr., Lake Wylie, SC 29710 | 2007-03-06 |
| 1043369457 | John Frank Ruocco | Dentist | 140 Highway 274, Clover, SC 29710 | 2007-01-09 |
| Find all providers in zip 29710 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | LAKE WYLIE |
| Zip Code | 29710 |
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| 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.