NPIMap

Organization Active NPI

Pharmacy of J Iverson Riddle Development Center

Doing business as J Iverson Riddle Development Center

  • Long Term Care Pharmacy
  • Morganton, NC
National Provider Identifier
1033271002
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
02677 Issued in NC
Legal business name
PHARMACY OF J IVERSON RIDDLE DEVELOPMENT CENTER
Doing business as
J Iverson Riddle Development Center
Practice address
300 Enola Rd
Pharmacy Department
Morganton, NC 28655-4608
Phone
(828) 433-2653
Fax
(828) 433-2894
NPI assigned
Dec 15, 2006
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Janice Swearingen, RPHNPI 1245397058
Title
Director of Phcy SVCS
Phone
(828) 433-2683

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Compounding Pharmacy 3336C0004X
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X 02677 NC Primary

Addresses

Primary practice location

300 Enola Rd
Pharmacy Department
Morganton, NC 28655-4608

Mailing address

Cbo DHHS Controllers Ofc
2021 Mail Service Center
Raleigh, NC 27699-0001
Phone (919) 733-9867

Other identifiers 2

IdentifierTypeStateIssuer
2066483OtherPK
3406014MedicaidNC

Other names 1

  • J IVERSON RIDDLE DEVELOPMENT CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
J Iverson Riddle Developmental Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the 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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1033271002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CBO DHHS CONTROLLERS OFC",
            "address_2": "2021 MAIL SERVICE CENTER",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276990001",
            "telephone_number": "919-733-9867",
            "fax_number": "919-733-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ENOLA RD",
            "address_2": "PHARMACY DEPARTMENT",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554608",
            "telephone_number": "828-433-2653",
            "fax_number": "828-433-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY OF J IVERSON RIDDLE DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "SWEARINGEN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "DIRECTOR OF PHCY SVCS",
        "authorized_official_telephone_number": "828-433-2683",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "02677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2066483",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406014",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J IVERSON RIDDLE DEVELOPMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "J IVERSON RIDDLE DEVELOPMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.