Organization Active NPI

Community Pharmacy of Granite Falls, LLC

Doing business as Granite Drug Center

  • Pharmacist
  • Granite Falls, NC
National Provider Identifier
1043350804
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13303 Issued in NC
Legal business name
COMMUNITY PHARMACY OF GRANITE FALLS, LLC
Doing business as
Granite Drug Center
Practice address
21 Falls Ave
Granite Falls, NC 28630
Phone
(828) 396-2144
Fax
(828) 396-9561
NPI assigned
Feb 8, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Bryan Huffstetler, PHARMDNPI 1689196685
Title
Owner & Pic
Phone
(828) 396-2144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 13303 NC Primary
Pharmacy 333600000X 02793 NC

Addresses

Primary practice location

21 Falls Ave
Granite Falls, NC 28630

Mailing address

21 Falls Ave
Granite Falls, NC 28630
Phone (828) 396-2144

Other names 1

  • GRANITE DRUG CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191118000012 NC Part B Supplier - Pharmacy 5698107407 Practice locations: Granite Falls, NC

National Provider Directory

National Provider Directory

Locations

21 Falls Ave
Granite Falls, NC 28630
Phone (282) 396-2144

Practitioners & affiliated clinicians

Practitioners 2

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043350804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FALLS AVE",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "28630",
            "telephone_number": "828-396-2144",
            "fax_number": "828-396-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FALLS AVE",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "28630",
            "telephone_number": "828-396-2144",
            "fax_number": "828-396-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY OF GRANITE FALLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HUFFSTETLER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER & PIC",
        "authorized_official_telephone_number": "828-396-2144",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "13303",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "02793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANITE DRUG CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite Falls, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.