IVA DRUG STORE, INC. (NPI# 1770588097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770588097 |
| Entity Type | Organization |
| Organization Name | IVA DRUG STORE, INC. |
| Practice Address |
720 E Front St Iva SC 29655-9089 |
| Mailing Address |
720 East Front Street P.o. Box 26 Iva SC 29655 |
| Practice Telephone | 8643486138 |
| Practice Fax Number | 8643482220 |
| Mailing Telephone | 8643486138 |
| Mailing Fax Number | 8643482220 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | MR. LANCE P BOLES (PRESIDENT) |
| Authorized Official Telephone | 8643486138 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 50008094 | SC | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
50008094 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 741128 | 05 |
| Street Address |
720 E FRONT ST |
| City | IVA |
| State | SC |
| Zip Code | 29655-9089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487091724 | Tanya Danette Dickerson | Registered Nurse | 9104 Hwy 81 South, Iva, SC 29655 | 2013-05-28 |
| 1750693776 | Exalted Health & Rehab of Iva, LLC | Skilled Nursing Facility | 406 West Broad St, Iva, SC 29655 | 2010-07-07 |
| 1699979310 | Robert Marcelino Rivera Alburo | Family Medicine | 331 Antreville Highway, Iva, SC 29655 | 2007-06-14 |
| 1740208776 | Willow Creek Living Center, LLC | Skilled Nursing Facility | 406 West Broad Street, Iva, SC 29655 | 2006-07-17 |
| 1427025238 | Iva Rescue Squad | Ambulance | 9715 Highway 81 S, Iva, SC 29655 | 2006-03-01 |
| 1437793684 | Collyn Bowman Smith | Student in an Organized Health Care Education/Training Program | 722 Bowman Rd, Iva, SC 29655-8007 | 2019-10-31 |
| 1467406462 | Anderson County School District Three | Local Education Agency (LEA) | 335 W Front St, Iva, SC 29655-8702 | 2006-05-22 |
| 1942649660 | Beth Lynn Hughes | Registered Nurse | 335 W Front St, Iva, SC 29655-8702 | 2013-06-15 |
| 1992306963 | Kristen Brown Purdy | Registered Nurse | 121b Mullberry Ln, Iva, SC 29655-8783 | 2020-11-05 |
| 1760894000 | Nursing Nurture | Lactation Consultant, Non-RN | 608 Parker Bowie Rd, Iva, SC 29655-9386 | 2014-05-21 |
| Find all providers in zip 29655 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on IVA DRUG STORE, INC..
| 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.