Community Pharmacy of Granite Falls, LLC
Organization Active NPI Pharmacist · Granite Falls, NC
NPI 1043350804 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1043350804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- 13303 (NC)
- Legal business name
- COMMUNITY PHARMACY OF GRANITE FALLS, LLC
- Practice address
- 21 Falls Ave
Granite Falls, NC 28630 - Phone
- (828) 396-2144
- Fax
- (828) 396-9561
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Bryan Huffstetler, PHARMD
- Title
- Owner & Pic
- Phone
- (828) 396-2144
Practitioners 2
-
Bryan Huffstetler, PHARMD
-
Jeffrey Allen Martin, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191118000012 | NC | Part B Supplier - Pharmacy | 5698107407 | Practice locations: Granite Falls, NC |
National Provider Directory
Locations
21 Falls Ave
Granite Falls, NC 28630
Phone (282) 396-2144
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 13303 | NC | Yes |
| 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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3406647 | Other | NC | NCPDP |
| 0145136 | Medicaid | NC |
Other names
- GRANITE DRUG CENTER
Other providers in Granite Falls, NC
- Annette Chontos
- Belinda K Clark
- Kyle Alden Clontz
- Terry L Coffey
- Ashley Ciriano Cohn
- Tiffany Connelly
- Emily Blake Cook
- Heather Cooper
- Jessica Berry Crouch
- Hannah Grace Crowder
All providers in Granite Falls, NC · Pharmacist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.