MCLEOD LORIS SEACOAST HOSPITAL (NPI# 1629387352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629387352 |
| Entity Type | Organization |
| Organization Name | MCLEOD LORIS SEACOAST HOSPITAL |
| Other Organization Name | LORIS EXTENDED CARE PHARMACY |
| Practice Address |
3655 Mitchell St Loris SC 29569-2827 |
| Mailing Address |
Po Box 100567 Florence SC 29502-0567 |
| Practice Telephone | 8437167178 |
| Practice Fax Number | 8437167179 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2019-02-25 |
| Authorized Official Name | SAMUEL FULTON ERVIN III (SR VP AND CFO) |
| Authorized Official Telephone | 8437772910 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCLEOD HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
13707 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2133930 | 01 | |
| SC | MEDICARE | 7498330001 | 01 |
| Other Name | Type Code |
|---|---|
| Loris Extended Care Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619534112 | Mcleod Loris Seacoast Hospital | Pharmacy | 4000 Hwy 9 East, Outpatient Pharmacy, Little River, SC 29566 | 2019-05-21 |
| 1588941520 | Mcleod Loris Seacoast Hospital | Skilled Nursing Facility | 3620 Stevens St, Loris, SC 29569-2953 | 2011-11-04 |
| 1265708119 | Mcleod Loris Seacoast Hospital | Emergency Medicine | 3655 Mitchell St, Loris, SC 29569-2827 | 2012-03-26 |
| 1306123344 | Mcleod Loris Seacoast Hospital | General Acute Care Hospital | 3655 Mitchell St, Loris, SC 29569-2827 | 2011-11-04 |
| Street Address |
3655 MITCHELL ST |
| City | LORIS |
| State | SC |
| Zip Code | 29569-2827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467441329 | James N Moore IIi | Family Medicine | 3655 Mitchell St, Loris, SC 29569-2827 | 2005-10-13 |
| 1437785888 | Hunter Tyson Chestnut | Registered Nurse | 3655 Mitchell St, Loris, SC 29569-2827 | 2020-03-17 |
| 1700417474 | Madeline Soucy | Nurse Practitioner | 3655 Mitchell St, Loris, SC 29569-2827 | 2020-01-30 |
| 1730627712 | Chad Dewayne Buffkin | Emergency Medicine | 3655 Mitchell St, Loris, SC 29569-2827 | 2017-02-09 |
| 1093172256 | Joann Hannah | Nurse Anesthetist, Certified Registered | 3655 Mitchell St, Loris, SC 29569-2827 | 2016-01-19 |
| 1699148569 | Horizon Emergency Physicians, LLC | Physician Assistant | 3655 Mitchell St, Loris, SC 29569-2827 | 2015-11-02 |
| 1376916114 | Symposium Emergency Physicians, LLC | Nurse Practitioner | 3655 Mitchell St, Loris, SC 29569-2827 | 2015-11-02 |
| 1497177216 | David Justin Guthrie | Registered Nurse | 3655 Mitchell St, Loris, SC 29569-2827 | 2014-01-14 |
| 1962753988 | Mohamed Bassiouny | Internal Medicine | 3655 Mitchell St, Loris, SC 29569-2827 | 2012-10-01 |
| 1265708119 | Mcleod Loris Seacoast Hospital | Emergency Medicine | 3655 Mitchell St, Loris, SC 29569-2827 | 2012-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427464247 | Denise Logan | Dietitian, Registered | 3811 Walnut St, Loris, SC 29569 | 2014-07-02 |
| 1801231634 | Melissa Ann Miara | Internal Medicine | 3617 Casey St Ste C, Loris, SC 29569 | 2013-05-07 |
| 1356684161 | Gwyn Gordon Mcgutchen | Dentist | 3681 Spivey St., Loris, SC 29569 | 2013-03-29 |
| 1336486174 | Winferd Dale Holt | Dentist | 3980 Main Street, Loris, SC 29569 | 2013-01-14 |
| 1528314325 | Southern Living Emergency Physicians LLC | Physician Assistant | 6988 Mitchell Street, Loris, SC 29569 | 2012-07-30 |
| 1124347604 | Regina F. Holmes | Nurse Practitioner | Agape Senior Primary Care Inc Dba Main Street Physician, 3612 Mitchell Street, Loris, SC 29569 | 2010-05-24 |
| 1801914122 | Dr Gwyn Gordon Mccutchen Inc | Dentist | 3681 Spivey Street, Loris, SC 29569 | 2007-03-26 |
| 1700911203 | Twin States Helping Hands | Home Health | 1620 Hwy 701 N, Loris, SC 29569 | 2007-02-23 |
| 1306922646 | Loris Community Hospital District | Clinic/Center | 3204 Casey St, Loris, SC 29569 | 2006-10-30 |
| 1619074119 | South Carolina Cvs Pharmacy LLC | Pharmacy | 4767 Broad St, Loris, SC 29569 | 2006-09-20 |
| Find all providers in zip 29569 | ||||
| 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 |
|---|---|---|---|---|
| 1104069707 | Meds & More LLC | Pharmacy | 3914 Main St, Loris, SC 29569-3018 | 2009-04-13 |
| 1619074119 | South Carolina Cvs Pharmacy LLC | Pharmacy | 4767 Broad St, Loris, SC 29569 | 2006-09-20 |
| 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 |
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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.