1. Home
  2. Directory
  3. South Carolina
  4. Mount Pleasant
  5. Pharmacy
  6. NPI Profile

TIDEWATER PHARMACY & COMPOUNDING
NPI 1053705772
Pharmacy - Compounding Pharmacy in Mount Pleasant, SC

Active since March 19, 2015
421 JOHNNIE DODDS BLVD, STE 100, MOUNT PLEASANT, SC 29464(843) 375-6310(843) 375-6311 Get Directions Write a Review

NPPES record last updated: January 31, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tidewater Pharmacy & Compounding NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIDEWATER PHARMACY & COMPOUNDING (NPI 1053705772) is a healthcare organization registered as a compounding pharmacy in Mount Pleasant, South Carolina and active in the NPI registry since March 2015. The organization lists Chad Straughan, Owner/pharmacist, as its authorized official.

NPPES Registry Identity

NPI1053705772
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameTIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Location Address421 JOHNNIE DODDS BLVD, STE 100Mount Pleasant, SC 29464
Mailing Address421 Johnnie Dodds Blvd, Ste 100Mount Pleasant, SC 29464-3052 · (478) 954-1178 · Fax (843) 375-6311
Phone(843) 375-6310
Fax(843) 375-6311
Organization SubpartNo
Authorized OfficialChad StraughanOwner/pharmacist · (843) 375-6310
Enumeration DateMarch 19, 2015
Last NPPES UpdateJanuary 31, 2016
✔ NPI 1053705772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in SC · 35780
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
421 JOHNNIE DODDS BLVD, Mount Pleasant, SC 29464
Open in Google Maps ↗

Other Names 1

Doing Business AsTidewater Pharmacy & Compounding

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Pharmacy (Specialty Pharmacy)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310
TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Durable Medical Equipment & Medical Supplies
421 JOHNNIE DODDS BLVD
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310
HEATHER D QUINN PHARMD
Pharmacist
421 JOHNNIE DODDS BLVD
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310
TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Pharmacy (Community/Retail Pharmacy)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310
TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Prosthetic/Orthotic Supplier
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310
TIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Durable Medical Equipment & Medical Supplies (Customized Equipment)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tidewater Pharmacy & Medical Supply LLC's NPI number?

The NPI number for Tidewater Pharmacy & Medical Supply LLC is 1053705772. It was assigned to this organization in the NPPES registry on March 19, 2015. The provider is doing business as Tidewater Pharmacy & Compounding.

Where is Tidewater Pharmacy & Medical Supply LLC located?

Tidewater Pharmacy & Medical Supply LLC is located at 421 Johnnie Dodds Blvd Ste 100, Mount Pleasant, SC 29464. The listed phone number is (843) 375-6310.

What is Tidewater Pharmacy & Medical Supply LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

When was this NPI record last updated?

The NPPES record for Tidewater Pharmacy & Medical Supply LLC was last updated on January 31, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.