NPIMap

Organization Active NPI

Wilkes Family Pharmacy

  • Pharmacy
  • Wilkesboro, NC
National Provider Identifier
1023389343
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
10652 Issued in NC
Legal business name
WILKES FAMILY PHARMACY
Practice address
1300 Westwood LN Ste a
Wilkesboro, NC 28697-2638
Phone
(336) 667-9347
Fax
(336) 667-9350
NPI assigned
Jan 18, 2012
Last updated
Jan 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Donald Lee Manus Jr.NPI 1740566892
Title
Pharmacist/Owner
Phone
(336) 667-9347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 10652 NC Primary

Addresses

Primary practice location

1300 Westwood LN Ste a
Wilkesboro, NC 28697-2638

Mailing address

1300 Westwood LN Ste a
Wilkesboro, NC 28697-2638
Phone (336) 667-9347

Other identifiers 2

IdentifierTypeStateIssuer
2801295OtherNCMEDICARE PTAN
0855188MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1023389343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 WESTWOOD LN STE A",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972638",
            "telephone_number": "336-667-9347",
            "fax_number": "336-667-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WESTWOOD LN STE A",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286972638",
            "telephone_number": "336-667-9347",
            "fax_number": "336-667-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKES FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "MANUS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "336-667-9347",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "10652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2801295",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0855188",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.