Healthcare Provider Details

I. General information

NPI: 1487931341
Provider Name (Legal Business Name): LITTLE RIVER MEDICAL CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 CAROLINA EXCHANGE DR
MYRTLE BEACH SC
29579-4220
US

IV. Provider business mailing address

PO BOX 547
LITTLE RIVER SC
29566-0547
US

V. Phone/Fax

Practice location:
  • Phone: 843-663-8051
  • Fax: 843-663-8382
Mailing address:
  • Phone: 843-663-8031
  • Fax: 843-663-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number13556
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTOPHER L CHIPLINSKI
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD
Phone: 843-663-8031