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TIDEWATER PHARMACY & COMPOUNDING
NPI 1962896688
Durable Medical Equipment & Medical Supplies - Customized Equipment 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 1962896688) is a healthcare organization registered as a customized equipment 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

NPI1962896688
Entity TypeOrganization
Primary Taxonomy332BC3200X
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 · (843) 375-6310 · Fax (843) 375-6311
Phone(843) 375-6310
Fax(843) 375-6311
Organization SubpartNo
Authorized OfficialChad StraughanOwner/pharmacist · (478) 954-1178
Enumeration DateMarch 19, 2015
Last NPPES UpdateJanuary 31, 2016
✔ NPI 1962896688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical Supplies · Customized EquipmentSuppliers
Taxonomy Code332BC3200X
License✔ Licensed in SC · 35780
421 JOHNNIE DODDS BLVD, Mount Pleasant, SC 29464
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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 (Compounding Pharmacy)
421 JOHNNIE DODDS BLVD, STE 100
MOUNT PLEASANT, SC 29464
Charleston County (843) 375-6310
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

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 1962896688. 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 Durable Medical Equipment & Medical Supplies, specializing in Customized Equipment, with taxonomy code 332BC3200X.

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.