NPIMap

Organization Active NPI

Eastern Carolina Pharmacy Care Inc

Doing business as Realo Discount Drug Store

  • Community/Retail Pharmacy
  • Kinston, NC
National Provider Identifier
1144241993
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
09305 Issued in NC
Legal business name
EASTERN CAROLINA PHARMACY CARE INC
Doing business as
Realo Discount Drug Store
Practice address
1302 W Vernon Ave
Kinston, NC 28504-3528
Phone
(252) 523-6069
Fax
(252) 523-3497
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Warren Hardy Creech II, RPH
Title
Owner/President
Phone
(252) 527-6929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 09305 NC Primary

Addresses

Primary practice location

1302 W Vernon Ave
Kinston, NC 28504-3528

Mailing address

1302 W Vernon Ave
Kinston, NC 28504-3528
Phone (252) 523-6069

Other identifiers 1

IdentifierTypeStateIssuer
2068787OtherPK

Other names 1

  • REALO DISCOUNT DRUG STORE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080714000110 NC Part B Supplier - Mass Immunization (Roster Biller Only) 3072685759 1 other NPI on this enrollment
Practice locations: Kinston, NC
O20100930097911 NC DME Supplier - Pharmacy 3072685759 Practice locations: Kinston, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Eastern Carolina Pharmacy Care Inc3 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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1144241993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 W VERNON AVE",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285043528",
            "telephone_number": "252-523-6069",
            "fax_number": "252-523-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W VERNON AVE",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285043528",
            "telephone_number": "252-523-6069",
            "fax_number": "252-523-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CAROLINA PHARMACY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "CREECH",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "HARDY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "252-527-6929",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2068787",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REALO DISCOUNT DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.