Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ted Tristan Nussbaum, RPH

Individual provider Pharmacist · NPI 1497052666

Ted Tristan Nussbaum, RPH is a Pharmacist in Moncks Corner, South Carolina. Licensed in South Carolina. Registered with an NPI since 2011.

Licensed in
SC
In the registry since
2011
What do these letters mean?
RPH — Registered Pharmacist
A pharmacist licensed by a state board.

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Practice location Address checks out

1008 Old Highway 52 Ste G
Moncks Corner, SC 29461-3011
Phone: (843) 899-4700
Fax: (843) 899-4702
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 11560 (SC)

Record details

NPI number1497052666
Entity typeIndividual (Type 1)
GenderMale
Credentials RPH
Sole proprietorNo
NPI enumeratedFebruary 23, 2011
Last updated in NPPESJune 10, 2025
Certification dateJune 10, 2025

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