Individual provider Active NPI

Page Hardison Feudale, RPH

  • Pharmacist
  • Graham, NC
National Provider Identifier
1053672717
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8092 Issued in NC
Practice address
210 E Elm St Ste a
Graham, NC 27253-3055
Phone
(336) 226-4401
Fax
(336) 228-9996
NPI assigned
May 30, 2012
Last updated
May 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8092 NC Primary

Addresses

Primary practice location

210 E Elm St Ste a
Graham, NC 27253-3055

Mailing address

210 E Elm St Ste a
Graham, NC 27253-3055
Phone (336) 226-4401

Other identifiers 1

IdentifierTypeStateIssuer
8092OtherNCNORTH CAROLINA BOARD OF PHARMACY LISCENSE

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
8092NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
South Court Drug Co Past Accepting new patients
South Court Drug Company Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1053672717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E ELM ST STE A",
            "city": "GRAHAM",
            "state": "NC",
            "postal_code": "272533055",
            "telephone_number": "336-226-4401",
            "fax_number": "336-228-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E ELM ST STE A",
            "city": "GRAHAM",
            "state": "NC",
            "postal_code": "272533055",
            "telephone_number": "336-226-4401",
            "fax_number": "336-228-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEUDALE",
        "first_name": "PAGE",
        "middle_name": "HARDISON",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "8092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF PHARMACY LISCENSE",
            "identifier": "8092",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Graham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.