Organization Active NPI

Food Lion LLC

Doing business as Food Lion Pharmacy #1358

  • Community/Retail Pharmacy
  • Raleigh, NC
National Provider Identifier
1053404426
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7597 Issued in NC
Legal business name
FOOD LION LLC
Doing business as
Food Lion Pharmacy #1358
Practice address
1121 Falls River Ave
Raleigh, NC 27614-6731
Phone
(919) 847-4235
Fax
(919) 847-4940
NPI assigned
Sep 30, 2006
Last updated
May 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Margaret M Ham
Title
President
Phone
(207) 885-7454

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Customized Equipment (DME) 332BC3200X NU
Community/Retail Pharmacy 3336C0003X 7597 NC Primary

Addresses

Primary practice location

1121 Falls River Ave
Raleigh, NC 27614-6731

Mailing address

PO Box 1000
Mailsort 3000
Portland, ME 04104-5005
Phone (207) 885-7454

Other identifiers 2

IdentifierTypeStateIssuer
0920142MedicaidNC
3437743OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • FOOD LION PHARMACY #1358 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930091436 NC DME Supplier - Pharmacy 3971615923 Practice locations: Raleigh, NC
O20140625002142 NC Part B Supplier - Mass Immunization (Roster Biller Only) 3971615923 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sanford, NC; Stedman, NC; Siler City, NC; Salisbury, NC; Roxboro, NC; Raleigh, NC; Raeigh, NC; Pikeville, NC…
O20151214000007 SC Part B Supplier - Mass Immunization (Roster Biller Only) 3971615923 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenwood, SC; N Augusta, SC; Rock Hill, SC

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Food Lion LLC1121 Falls River Ave, Raleigh, NC 27614-6731(919) 847-4235 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2005

National Provider Directory

National Provider Directory
Tax ID family
Food Lion LLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

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": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1053404426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "MAILSORT 3000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045005",
            "telephone_number": "207-885-7454",
            "fax_number": "207-885-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 FALLS RIVER AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146731",
            "telephone_number": "919-847-4235",
            "fax_number": "919-847-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOD LION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-885-7454"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "7597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0920142",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3437743",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOD LION PHARMACY #1358",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.