MEDICARE: MICA PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	15216	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2146051	OTHER		PK

General Provider Information

NPI Number	:	1215983952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICA PHARMACY LLC

Provider Business Mailing Address
First Line	:	3907 EDMUND HWY
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29170-1944
Country	:	US
Telephone Number	:	803-755-9600
Fax Number	:	803-755-3271

Provider Business Practice Location Address
First Line	:	3907 EDMUND HWY
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29170-1944
Country	:	US
Telephone Number	:	803-755-9600
Fax Number	:	803-755-3271

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JOSEPH BLIZZARD
Credential	:
Telephone Number	:	803-755-9600

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	06/07/2016

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1023129673 — GEORGE E. DAWN RPH
Practice Location Address:

3901D EDMUND HWY
WEST COLUMBIA, SC
29170-1944

Practice Phone: 803-755-9600
Practice Fax: 803-755-3271

1043371339 — DR. MICHAEL WAYNE STURKIE JR. D.M.D.
Practice Location Address:

3901 EDMUND HWY , SUITE C
WEST COLUMBIA, SC
29170-1944

Practice Phone: 803-755-3953
Practice Fax: 803-755-6903

1316301393 — SKRIP SHOPPE 2 LLC
Practice Location Address:

3907 EDMUND HWY STE A
WEST COLUMBIA, SC
29170-1944

Practice Phone: 803-764-2408
Practice Fax: 803-888-6123

1891753505 — ORTHOCARE SOLUTIONS, INC
Practice Location Address:

5850 WATERLOO RD STE 140
COLUMBIA, MD
21045-1944

Practice Phone: 301-990-1640
Practice Fax: 301-990-1882

1932384666 — PRO-HEALTH CARE, INC
Practice Location Address:

4710 CENTRAL AVE NE
COLUMBIA HEIGHTS, MN
55421-1944

Practice Phone: 763-746-8155
Practice Fax: 763-746-8154

Directions to “MICA PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.