NPIMap

Organization Active NPI

Familymed Pharmacy of Maiden

  • Community/Retail Pharmacy
  • Maiden, NC
National Provider Identifier
1053493841
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
09028 Issued in NC
Legal business name
FAMILYMED PHARMACY OF MAIDEN
Doing business as
Familymed Pharmacy of Maiden
Practice address
625 E Main St
Maiden, NC 28650-1419
Phone
(828) 428-1501
Fax
(828) 428-4138
NPI assigned
Oct 20, 2006
Last updated
Oct 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Gregory Shull, RPHNPI 1467466672
Title
Pic
Phone
(828) 428-1501

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
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 09028 NC Primary

Addresses

Primary practice location

625 E Main St
Maiden, NC 28650-1419

Mailing address

625 E Main St
Maiden, NC 28650-1419

Other identifiers 2

IdentifierTypeStateIssuer
0186256MedicaidNC
3402827OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • FAMILYMED PHARMACY OF MAIDEN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Care RX3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

625 E Main St
Maiden, NC 28650
Phone (828) 428-1501

Practitioners & affiliated clinicians

Practitioners 1

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": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1053493841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E MAIN ST",
            "city": "MAIDEN",
            "state": "NC",
            "postal_code": "286501419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E MAIN ST",
            "city": "MAIDEN",
            "state": "NC",
            "postal_code": "286501419",
            "telephone_number": "828-428-1501",
            "fax_number": "828-428-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILYMED PHARMACY OF MAIDEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "SHULL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "828-428-1501",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0186256",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3402827",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILYMED PHARMACY OF MAIDEN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maiden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.