Active NPI
Reidsville Pharmacy Inc
- Community/Retail Pharmacy
- Reidsville, NC
National Provider Identifier
1104986710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- REIDSVILLE PHARMACY INC
- Practice address
- 924 S Scales St
Reidsville, NC 27320-5318 - Phone
- (336) 342-9175
- Fax
- (336) 634-1308
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tammy Coble Hall, RPH
- Title
- President
- Phone
- (336) 342-9175
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4859 | NC | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
924 S Scales St
Reidsville, NC 27320-5318
Mailing address
924 S Scales St
Reidsville, NC 27320-5318
Phone (336) 342-9175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3424683 | Other | NC | NABP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230920000309 | NC | Part B Supplier - Pharmacy | 6507220886 | Practice locations: Reidsville, NC |
National Provider Directory
National Provider DirectoryLocations
924 S Scales St
Reidsville, NC 27320
Phone (336) 342-9175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750291200000",
"number": "1104986710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 S SCALES ST",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273205318",
"telephone_number": "336-342-9175",
"fax_number": "336-634-1308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "924 S SCALES ST",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273205318",
"telephone_number": "336-342-9175",
"fax_number": "336-634-1308"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REIDSVILLE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-12",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A",
"authorized_official_last_name": "HALL",
"authorized_official_first_name": "TAMMY",
"authorized_official_middle_name": "COBLE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "336-342-9175",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "NC",
"license": "4859",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "3424683",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Reidsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.