TIDEWATER PHARMACY & COMPOUNDING
NPI 1760876486
Prosthetic/Orthotic Supplier 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 1760876486) is a healthcare organization registered as a prosthetic/orthotic supplier 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

NPI1760876486
Entity TypeOrganization
Primary Taxonomy335E00000X
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 29464-2689 · (843) 375-6310 · Fax (843) 375-6311
Fax(843) 375-6311
Organization SubpartNo
Authorized OfficialChad StraughanOwner/pharmacist · (843) 375-6310
Enumeration DateMarch 19, 2015
Last NPPES UpdateJanuary 31, 2016
NPI 1760876486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
License Licensed in SC · 35780
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
421 JOHNNIE DODDS BLVD, Mount Pleasant, SC 29464

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.

Pharmacy (Compounding Pharmacy)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Pharmacy (Specialty Pharmacy)
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
Durable Medical Equipment & Medical Supplies (Customized Equipment)
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 1760876486. 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 Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

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.