Healthcare Provider Details

I. General information

NPI: 1487523221
Provider Name (Legal Business Name): PHOENIX PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 HOSPITAL DRIVE SUITE 102
MOUNT PLEASANT SC
29464
US

IV. Provider business mailing address

1204 HOSPITAL DRIVE SUITE 102
MOUNT PLEASANT SC
29464
US

V. Phone/Fax

Practice location:
  • Phone: 854-238-4499
  • Fax: 854-238-4477
Mailing address:
  • Phone: 854-238-4499
  • Fax: 854-238-4477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHAD STRAUGHAN
Title or Position: OWNER
Credential: PHARMD
Phone: 854-238-4499