NPIMap

Organization Active NPI

Beach RX, Inc.

Doing business as Beach Pharmacy of Avon

  • Community/Retail Pharmacy
  • Avon, NC
National Provider Identifier
1114001955
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
04503 Issued in NC
Legal business name
BEACH RX, INC.
Doing business as
Beach Pharmacy of Avon
Practice address
41934 Hwy 12
Avon, NC 27915
Phone
(252) 995-3811
Fax
(252) 995-7955
NPI assigned
Oct 25, 2006
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Matthew ThornbroughNPI 1760717169
Title
President/Pharmacist
Phone
(529) 995-3811

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Community/Retail Pharmacy 3336C0003X 04503 NC Primary

Addresses

Primary practice location

41934 Hwy 12
Avon, NC 27915

Mailing address

P.O. Box 660
Avon, NC 27915
Phone (252) 995-3811

Other identifiers 2

IdentifierTypeStateIssuer
0285148MedicaidNC
2069219OtherPK

Other names 1

  • BEACH PHARMACY OF AVON Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220728000243 NC Part B Supplier - Pharmacy 2365824000 1 other NPI on this enrollment
Practice locations: Hatteras, NC; Avon, NC

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Beach Pharmacy II LTD3 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.

Practitioners & affiliated clinicians

Practitioners 3

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1114001955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 660",
            "city": "AVON",
            "state": "NC",
            "postal_code": "27915",
            "telephone_number": "252-995-3811",
            "fax_number": "252-995-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41934 HWY 12",
            "city": "AVON",
            "state": "NC",
            "postal_code": "27915",
            "telephone_number": "252-995-3811",
            "fax_number": "252-995-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH RX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "THORNBROUGH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "529-995-3811"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "04503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0285148",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2069219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEACH PHARMACY OF AVON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BEACH PHARMACY OF AVON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.

Verify at the official NPI Registry.