Healthcare Provider Details

I. General information

NPI: 1497975437
Provider Name (Legal Business Name): OKADIS PHARMACY CARE CLINIC &CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 ALLIUM WAY
TAYLORS SC
29687-5461
US

IV. Provider business mailing address

PO BOX 5167
GREENVILLE SC
29606-5167
US

V. Phone/Fax

Practice location:
  • Phone: 864-244-1570
  • Fax: 864-244-1560
Mailing address:
  • Phone: 864-244-1570
  • Fax: 864-244-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number008738
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number008738
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number008738
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number008738
License Number StateSC
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number008738
License Number StateSC

VIII. Authorized Official

Name: DR. CYRIL JIDE OKADIGWE
Title or Position: CEO AND FOUNDER
Credential: PHARM.D
Phone: 864-244-1570