Black River Grocery LLC
Black River Grocery LLC is a healthcare organization registered as Community/Retail Pharmacy in Andrews, SC, holding Type 2 (organization) NPI 1689730913 since 2006. The authorized official on file is Troy Lamb, Pic.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1689730913 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Black River Grocery LLC |
| Other name | <Unavail> |
| Practice address | 15 W ASHLAND ST, Andrews, SC, 29510 |
| Phone | 8432643291 |
| Fax | 8432645425 |
| Enumeration date | 2006-12-29 |
| Last updated in NPPES | 2025-10-31 |
Authorized official
| Name | Troy Lamb |
|---|---|
| Title | Pic |
| Phone | 8432643291 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Primary | 14725 | SC |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2141517 | Other | — | PK |
Copy-ready billing details
Provider: Black River Grocery LLC NPI: 1689730913 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 15 W ASHLAND ST, Andrews, SC, 29510
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1275883845 | Tracey Haddock | Individual | Pharmacist | Andrews, SC |
| 1952196867 | Black River Grocery LLC | Organization | Pharmacy | Andrews, SC |
Verify this record
Cross-check NPI 1689730913 against the authoritative CMS record: view Black River Grocery LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Black River Grocery LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-10-31.