TIDEWATER PHARMACY & COMPOUNDING
NPI 1417316548
Pharmacy - Specialty Pharmacy in Mount Pleasant, SC

Active since February 17, 2016
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: February 17, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Tidewater Pharmacy & Compounding NPPES

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

TIDEWATER PHARMACY & COMPOUNDING (NPI 1417316548) is a healthcare organization registered as a specialty pharmacy in Mount Pleasant, South Carolina and active in the NPI registry since February 2016. The organization lists Chad Louis Straughan, Owner/pharmacist, as its authorized official.

NPPES Registry Identity

NPI1417316548
Entity TypeOrganization
Primary Taxonomy3336S0011X
Legal Business NameTIDEWATER PHARMACY & MEDICAL SUPPLY LLC
Location Address421 JOHNNIE DODDS BLVD, STE 100Mount Pleasant, SC 29464-3052
Mailing Address421 Johnnie Dodds Blvd, Ste 100Mount Pleasant, SC 29464-3052 · (843) 375-6310 · Fax (843) 375-6311
Fax(843) 375-6311
Organization SubpartNo
Authorized OfficialChad Louis StraughanOwner/pharmacist · (842) 375-6310
Enumeration DateFebruary 17, 2016
NPI 1417316548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Specialty PharmacySuppliers
Taxonomy Code3336S0011X
License Licensed in SC · 15890
Definition

A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

421 JOHNNIE DODDS BLVD, Mount Pleasant, SC 29464

Other Names 1

Doing Business AsTidewater Pharmacy & Compounding

Other Identifiers 1

Medicaid715890SC

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.

Durable Medical Equipment & Medical Supplies (Customized Equipment)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Pharmacy (Compounding Pharmacy)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Prosthetic/Orthotic Supplier
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Durable Medical Equipment & Medical Supplies
421 JOHNNIE DODDS BLVD
MOUNT PLEASANT, SC 29464
Pharmacist
421 JOHNNIE DODDS BLVD
MOUNT PLEASANT, SC 29464
Pharmacy (Community/Retail Pharmacy)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464

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 1417316548. It was assigned to this organization in the NPPES registry on February 17, 2016.

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 Specialty Pharmacy, with taxonomy code 3336S0011X.

When was this NPI record last updated?

The NPPES record for Tidewater Pharmacy & Medical Supply LLC was last updated on February 17, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.