NPIMap

Organization Active NPI

Bladen Lakes Community Health Center

  • Community/Retail Pharmacy
  • Tar Heel, NC
National Provider Identifier
1124298773
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
NC10010 Issued in NC
Legal business name
BLADEN LAKES COMMUNITY HEALTH CENTER
Doing business as
Bladen Lakes Community Health Center
Practice address
16526 NC Highway 87 W
Tar Heel, NC 28392-8608
Phone
(910) 972-5720
NPI assigned
Mar 10, 2008
Last updated
Jan 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Authorized official

Name
Pamela Tripp
Title
Ceo
Phone
(910) 567-6194

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X NC10010 NC Primary

Addresses

Primary practice location

16526 NC Highway 87 W
Tar Heel, NC 28392-8608

Mailing address

16526 NC Highway 87 W
Tar Heel, NC 28392-8608

Other names 1

  • BLADEN LAKES COMMUNITY HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tri-Co Community HLTH Ctr30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1124298773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16526 NC HIGHWAY 87 W",
            "city": "TAR HEEL",
            "state": "NC",
            "postal_code": "283928608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16526 NC HIGHWAY 87 W",
            "city": "TAR HEEL",
            "state": "NC",
            "postal_code": "283928608",
            "telephone_number": "910-972-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLADEN LAKES COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-567-6194"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "NC10010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLADEN LAKES COMMUNITY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BLADEN LAKES COMMUNITY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tar Heel, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.