NPIMap

Organization Active NPI

North Carolina a T State University

Doing business as Sebastian Student Health Center

  • Clinic Pharmacy
  • Greensboro, NC
National Provider Identifier
1114234903
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
04312 Issued in NC
Legal business name
NORTH CAROLINA A T STATE UNIVERSITY
Doing business as
Sebastian Student Health Center
Practice address
112. N. Benbow Road
Greensboro, NC 27411-0001
Phone
(336) 285-2908
Fax
(336) 256-2903
NPI assigned
Sep 1, 2010
Last updated
May 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Authorized official

Name
Mrs. Bannie H Hatch, RPH
Title
Pharmacy Manager
Phone
(336) 285-2908

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 04312 NC Primary
Institutional Pharmacy 3336I0012X NU

Addresses

Primary practice location

112. N. Benbow Road
Greensboro, NC 27411-0001

Mailing address

112. N. Benbow Road
Greensboro, NC 27411-0001
Phone (336) 285-2908

Other identifiers 1

IdentifierTypeStateIssuer
3421358OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Sebastian Student Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Carolina at State University5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1114234903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112. N. BENBOW ROAD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274110001",
            "telephone_number": "336-285-2908",
            "fax_number": "336-256-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112. N. BENBOW ROAD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274110001",
            "telephone_number": "336-285-2908",
            "fax_number": "336-256-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA A T STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "HATCH",
        "authorized_official_first_name": "BANNIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "336-285-2908",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": "04312",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3421358",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sebastian Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.