Organization Active NPI

Crystal Coast Pharmacy

Doing business as Crystal Coast Pharmacy & Home Medical

  • Pharmacist
  • Cape Carteret, NC
National Provider Identifier
1063478774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8305 Issued in NC
Legal business name
CRYSTAL COAST PHARMACY
Doing business as
Crystal Coast Pharmacy & Home Medical
Practice address
319 WB McLean Blvd
Cape Carteret, NC 28584-8516
Phone
(252) 393-3345
Fax
(252) 393-3346
NPI assigned
Apr 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeff Albritton, RPH
Title
Owner
Phone
(252) 393-3345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 8305 NC Primary

Addresses

Primary practice location

319 WB McLean Blvd
Cape Carteret, NC 28584-8516

Mailing address

319 WB McLean Blvd
Cape Carteret, NC 28584-8516
Phone (252) 393-3345

Other identifiers 2

IdentifierTypeStateIssuer
046U8OtherNCBLUE CROSS BLUE SHIELD
7704096MedicaidNC

Other names 1

  • Crystal Coast Pharmacy & Home Medical Doing business as

National Provider Directory

National Provider Directory

Locations

319 Wb McLean Dr
Cape Carteret, NC 28584
Phone (252) 393-3345

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063478774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 WB MCLEAN BLVD",
            "city": "CAPE CARTERET",
            "state": "NC",
            "postal_code": "285848516",
            "telephone_number": "252-393-3345",
            "fax_number": "252-393-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 WB MCLEAN BLVD",
            "city": "CAPE CARTERET",
            "state": "NC",
            "postal_code": "285848516",
            "telephone_number": "252-393-3345",
            "fax_number": "252-393-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL COAST PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALBRITTON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-393-3345",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "8305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "046U8",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704096",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Coast Pharmacy & Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Carteret, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.