Active NPI
Community Family Pharmacy
- Community/Retail Pharmacy
- Shelby, NC
National Provider Identifier
1043204902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0235499 | Medicaid | NC | |
| 7700402 | Medicaid | NC |
Other names 2
- Community Family Pharmacy
- Shelby Family Pharmacy Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220121000913 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 9133245780 | Practice locations: Shelby, NC |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pharmacist
- Shelby, NC
- NPI 1083863443
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.