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Contact Information

OCEAN LAKES PHARMACY INC
1415 HWY 17 BUSINESS N
SURFSIDE BEACH, SC29575
 Phone: 843-238-5159
 Fax: 843-238-8270
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for OCEAN LAKES PHARMACY INC

NPI Number 1316020589
LBN Legal business name OCEAN LAKES PHARMACY INC
Authorized official ROGER WILLIAMS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/23/2006
Last updated 02/28/2017 - About 9 years ago
Identifiers
SC License # 50004721
SC Medicaid 611804
SC Medicaid 747216
SC Medicaid EN2106
Other 2088907 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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