NPIMap

Organization Active NPI

Mast Drug Co Inc

Doing business as Mast Long Term Care Williamston

  • Long Term Care Pharmacy
  • Williamston, NC
National Provider Identifier
1144396789
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5603 Issued in NC
Legal business name
MAST DRUG CO INC
Doing business as
Mast Long Term Care Williamston
Practice address
415 East Blvd
Williamston, NC 27892-2731
Phone
(252) 792-8216
Fax
(252) 792-7330
NPI assigned
Nov 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Polly Beal
Title
Admin MGR
Phone
(252) 438-3112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 5603 NC Primary

Addresses

Primary practice location

415 East Blvd
Williamston, NC 27892-2731

Mailing address

1910 Ross Mill Rd
Henderson, NC 27537-8789

Other identifiers 5

IdentifierTypeStateIssuer
9800034MedicaidMD
0585158MedicaidNC
3430307OtherOTHER ID NUMBER-COMMERCIAL NUMBER
8507376MedicaidVA
7701334MedicaidNC

Other names 1

  • MAST LONG TERM CARE WILLIAMSTON Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mast Drug Co Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144396789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROSS MILL RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275378789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 EAST BLVD",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922731",
            "telephone_number": "252-792-8216",
            "fax_number": "252-792-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAST DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "ADMIN MGR",
        "authorized_official_telephone_number": "252-438-3112"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "5603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9800034",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0585158",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3430307",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8507376",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7701334",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAST LONG TERM CARE WILLIAMSTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamston, 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.