NPIMap

Organization Active NPI

Askk LLC

  • Community/Retail Pharmacy
  • Winston Salem, NC
National Provider Identifier
1134548415
Registry record updated Sep 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
11987 Issued in NC
Legal business name
ASKK LLC
Practice address
3085 Waughtown St
Winston Salem, NC 27107-1634
Phone
(336) 830-8774
Fax
(336) 830-8775
NPI assigned
Apr 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2015

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

Authorized official

Name
Mr. Scottie Bryan Freeman
Title
President
Phone
(336) 830-8774

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 11987 NC
Customized Equipment (DME) 332BC3200X 11987 NC
Community/Retail Pharmacy 3336C0003X 11987 NC Primary
Compounding Pharmacy 3336C0004X 11987 NC

Addresses

Primary practice location

3085 Waughtown St
Winston Salem, NC 27107-1634

Mailing address

3085 Waughtown St
Winston Salem, NC 27107-1634
Phone (336) 830-8774

Other names 1

  • SOUTHSIDE DISCOUNT PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141229002211 NC Part B Supplier - Pharmacy 5496078370 Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

3085 Waughtown St
Winston Salem, NC 27107
Phone (336) 830-8774

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441411200000",
    "number": "1134548415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 WAUGHTOWN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271071634",
            "telephone_number": "336-830-8774",
            "fax_number": "336-830-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 WAUGHTOWN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271071634",
            "telephone_number": "336-830-8774",
            "fax_number": "336-830-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASKK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2015-09-05",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "SCOTTIE",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-830-8774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "11987",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NC",
            "license": "11987",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11987",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NC",
            "license": "11987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHSIDE DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2015; 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.