Prohealth Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11144 Issued in NC

Legal business name

PROHEALTH PHARMACY INC

Practice address

280 N Pointe Blvd
Mount Airy, NC 27030-2267

Phone

(336) 719-6010

Fax

(336) 719-6011

NPI assigned

Dec 13, 2011

Organization subpart

No

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

Authorized official

Name

Donald Gardner, PHARMD

Title

Owner

Phone

(336) 719-6006

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• ProHealth Pharmacy Doing business as

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1124396593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N POINTE BLVD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302267",
            "telephone_number": "336-719-6010",
            "fax_number": "336-719-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N POINTE BLVD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302267",
            "telephone_number": "336-719-6010",
            "fax_number": "336-719-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-719-6006",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133083",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProHealth Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Bartz Potter, FNP
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• Richard J. Preske, M.D.
• Prosperitas, LLC
• Maria Elizabeth Pruitt, PT
• Amy Leigh Puckett-Lawson, FNP-C
• Ritchie D Puckett, LCAS-A
• Stephanie Puckett, LPCA

• Community/Retail Pharmacy in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.