# CHARLESTON CLINICAL & HEALTH SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Plaza Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841373123
- **Authorized official:** DR. J. L. BRUEGGEMAN PHARM. D. (DIRECTOR)
- **Authorized official phone:** (843) 553-7121

## Contact information

- **Practice address:** 9301 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9103
- **Practice address phone:** (843) 553-7121
- **Practice address fax:** (843) 553-5800
- **Mailing address:** 9301 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9103
- **Mailing address phone:** (843) 553-7121
- **Mailing address fax:** (843) 553-5800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1807 | SC | — |
| 3336C0003X | Community/Retail Pharmacy | 001807 | SC | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 42-09892 | NCPDP | SC |
| 05 | — | 718076 | — | SC |