# PINE RIDGE INVESTORS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pine Ridge Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750527834
- **Authorized official:** KYLE MCHUGH (PRESIDENT)
- **Authorized official phone:** (803) 939-8489

## Contact information

- **Practice address:** 634 A PINE RIDGE DR, WEST COLUMBIA, SC 29172
- **Practice address phone:** (803) 955-3404
- **Practice address fax:** (803) 955-3406
- **Mailing address:** PO BOX 310, GASTON, SC 29053-0310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 50010273 | SC | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/19/2008
- **Last updated:** 01/22/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1750527834 | — | SC |
| 01 | — | 4228385 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |