BI-LO, LLC. (BI-LO PHARMACY #5105) - NPI NUMBER 1750474110

Summary

Provider Name: BI-LO, LLC. (BI-LO PHARMACY #5105)

NPI Number: 1750474110

Clasification: Durable Medical Equipment & Medical Supplies (332B00000X)

Address:
720 MAIN ST
NORTH MYRTLE BEACH, SC
ZIP 29582

Phone Number: (843) 249-8553



Detailed Information

BI-LO, LLC. is a durable medical equipment & medical supplies in North Myrtle Beach, SC. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient�s use in the home and that are usable for an extended period of time. The assigned NPI number for this provider is 1750474110 and is registered as an organization entity type.
The provider Is Doing Business As Bi-lo Pharmacy #5105.

The provider's business address is:

720 MAIN ST
NORTH MYRTLE BEACH, SC
ZIP 29582-030
Phone: (843) 249-8553
Fax: (843) 249-4794

The provider's authorized official is M. Sandlin Grimm .
The authorized official title is Secretary and has the following contact phone number (904) 783-5578.

The enumeration date for this NPI number is 9/30/2006 and was last updated on 6/28/2013.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 332B00000X Durable Medical Equipment & Medical Supplies 14445 SC No
2 3336C0003X Pharmacy Community/Retail Pharmacy Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 4222472 OTHER OTHER ID NUMBER-COMMERCIAL NUMBER
2 3866820042 MEDICARE NSC SC
3 714445 MEDICAID SC
4 781534 MEDICAID SC
5 DE2092 OTHER SC MEDICAID DME

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1750474110 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name BI-LO, LLC. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name BI-LO PHARMACY #5105 Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 720 MAIN ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name NORTH MYRTLE BEACH The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name SC The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 295823030 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 8432498553 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 8432494794 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 9/30/2006 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 6/28/2013 The date that a record was last updated or changed.
16 Authorized Official Last Name GRIMM The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name M. SANDLIN The first name of the authorized official.
18 Authorized Official Title or Position SECRETARY The title or position of the authorized official.
19 Authorized Official Telephone Number 9047835578 The 10-position telephone number of the authorized official.
20 Healthcare Provider Taxonomy Code 1 332B00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
21 Provider License Number 1 14445 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
22 Provider License Number State Code 1 SC The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
23 Healthcare Provider Primary Taxonomy Switch 1 N
24 Healthcare Provider Taxonomy Code 2 3336C0003X
25 Healthcare Provider Primary Taxonomy Switch 2 Y
26 Other Provider Identifier 1 4222472 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier Issuer 1 OTHER ID NUMBER-COMMERCIAL NUMBER
29 Other Provider Identifier 2 3866820042 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier Type Code 2 07 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier State 2 SC
32 Other Provider Identifier 3 714445 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier State 3 SC
35 Other Provider Identifier 4 781534 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
36 Other Provider Identifier Type Code 4 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
37 Other Provider Identifier State 4 SC
38 Other Provider Identifier 5 DE2092 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
39 Other Provider Identifier Type Code 5 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
40 Other Provider Identifier State 5 SC
41 Other Provider Identifier Issuer 5 MEDICAID DME
42 Is Organization Subpart Y
43 Parent Organization LBN BI-LO, LLC.
44 Parent Organization TIN

Similar Providers Nearby

NPI Provider Name NPI Type Taxonomy
1083697890 MEDICAL SERVICES OF AMERICA INC Organization Durable Medical Equipment & Medical Supplies
1194818559 BI-LO, LLC. Organization Durable Medical Equipment & Medical Supplies
1124045398 WAL-MART STORES EAST LP Organization Durable Medical Equipment & Medical Supplies
1063727691 EXPERT HOME MEDICAL. LLC Organization Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1356350151 OMNICARE OF NEW YORK, LLC Organization Durable Medical Equipment & Medical Supplies
1093835423 COASTAL HOME CARE Organization Durable Medical Equipment & Medical Supplies (Parenteral & Enteral Nutrition)
1255434791 SOUTH CAROLINA CVS PHARMACY LLC Organization Durable Medical Equipment & Medical Supplies
1225088974 RUONALA DURABLE MEDICAL EQUIPMENT INC. Organization Durable Medical Equipment & Medical Supplies
1396069621 BEACON RESPIRATORY SERVICES OF GEORGIA INC Organization Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1356674485 MOMMA & POPPA MOBILITY HOME MEDICAL LLC Organization Durable Medical Equipment & Medical Supplies
1386892214 MAKING YOU MOBILE, LLC Organization Durable Medical Equipment & Medical Supplies
1336409846 TARGET CORPORATION Organization Durable Medical Equipment & Medical Supplies


Download NPI Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.