Active NPI
Marvin Eugene Long II
- Pharmacist
- Matthews, NC
National Provider Identifier
1043797533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28129
- Practice address
- 1305 Matthews Township Pkwy
Matthews, NC 28105-4600 - Phone
- (704) 847-8508
- NPI assigned
- Jul 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28129 | NC | Primary |
Addresses
Primary practice location
1305 Matthews Township Pkwy
Matthews, NC 28105-4600
Mailing address
1813 Danbrooke Dr
Indian Trail, NC 28079-9400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28129 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532563200000",
"number": "1043797533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1813 DANBROOKE DR",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280799400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 MATTHEWS TOWNSHIP PKWY",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281054600",
"telephone_number": "704-847-8508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "MARVIN",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-26",
"last_updated": "2018-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "28129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.