Organization Active NPI

Community Family Pharmacy

  • Community/Retail Pharmacy
  • Shelby, NC
National Provider Identifier
1043204902
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
COMMUNITY FAMILY PHARMACY
Doing business as
Community Family Pharmacy
Practice address
1194 Wyke Rd
Shelby, NC 28150-4259
Phone
(704) 482-4457
Fax
(704) 487-5427
NPI assigned
Sep 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Carla Beam
Title
Owner
Phone
(704) 300-7197

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 082000 NC
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1194 Wyke Rd
Shelby, NC 28150-4259

Mailing address

1194 Wyke Rd
Shelby, NC 28150-4259
Phone (704) 482-4457

Other identifiers 2

IdentifierTypeStateIssuer
0235499MedicaidNC
7700402MedicaidNC

Other names 2

  • Community Family Pharmacy Doing business as
  • Shelby Family Pharmacy Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220121000913 NC Part B Supplier - Mass Immunization (Roster Biller Only) 9133245780 Practice locations: Shelby, NC

National Provider Directory

National Provider Directory

Locations

1194 Wyke Rd
Shelby, NC 28150
Phone (704) 482-4457

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1043204902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1194 WYKE RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504259",
            "telephone_number": "704-482-4457",
            "fax_number": "704-487-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1194 WYKE RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504259",
            "telephone_number": "704-482-4457",
            "fax_number": "704-487-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "BEAM",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-300-7197"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "082000",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235499",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700402",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelby Family Pharmacy Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.