Organization Active NPI

Hospital Pharmacy LTC

  • Long Term Care Pharmacy
  • Mount Airy, NC
National Provider Identifier
1144247826
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
08097 Issued in NC
Legal business name
HOSPITAL PHARMACY LTC
Practice address
814 Worth St
Mount Airy, NC 27030-4561
Phone
(336) 786-4171
Fax
(336) 786-8856
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Larry Patterson
Title
Owner/President
Phone
(336) 786-4171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 08097 NC Primary

Addresses

Primary practice location

814 Worth St
Mount Airy, NC 27030-4561

Mailing address

814 Worth St
Mount Airy, NC 27030-4561
Phone (336) 786-4171

Other identifiers 1

IdentifierTypeStateIssuer
0865635MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144247826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 WORTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304561",
            "telephone_number": "336-786-4171",
            "fax_number": "336-786-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 WORTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304561",
            "telephone_number": "336-786-4171",
            "fax_number": "336-786-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL PHARMACY LTC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "336-786-4171",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "08097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0865635",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.