Provider Demographics
NPI:1184597049
Name:PODARIS GROUP LLC
Entity type:Organization
Organization Name:PODARIS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GARLAND
Authorized Official - Last Name:NESBITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-276-4195
Mailing Address - Street 1:711 PALM BLVD
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2151
Mailing Address - Country:US
Mailing Address - Phone:843-353-3241
Mailing Address - Fax:954-708-1904
Practice Address - Street 1:1537 BEN SAWYER BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5533
Practice Address - Country:US
Practice Address - Phone:843-353-3241
Practice Address - Fax:954-708-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy