NPIMap

Organization Active NPI

Eastover Drug LLC

Doing business as Eastover Drug

  • Community/Retail Pharmacy
  • Eastover, NC
National Provider Identifier
1144542994
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10486 Issued in NC
Legal business name
EASTOVER DRUG LLC
Doing business as
Eastover Drug
Practice address
3591 Dunn Rd
Eastover, NC 28312-8794
Phone
(910) 483-4555
Fax
(910) 483-0996
NPI assigned
Feb 22, 2010
Last updated
Dec 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Authorized official

Name
Zachary HayesNPI 1043571870
Title
Pharmacy Manager
Phone
(910) 483-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X 10486 NC Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

3591 Dunn Rd
Eastover, NC 28312-8794

Mailing address

3947 Dunn Road
PMB 200
Fayeteville, NC 28312-8794
Phone (910) 483-4555

Other identifiers 2

IdentifierTypeStateIssuer
0266477MedicaidNC
3418541OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Eastover Drug Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101012001342 NC DME Supplier - Pharmacy 3274725999 Practice locations: Eastover, NC
O20130109000797 NC Part B Supplier - Mass Immunization (Roster Biller Only) 3274725999 Practice locations: Eastover, NC

National Provider Directory

National Provider Directory
Tax ID family
Eastover Drug2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1144542994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3947 DUNN ROAD",
            "address_2": "PMB 200",
            "city": "FAYETEVILLE",
            "state": "NC",
            "postal_code": "283128794",
            "telephone_number": "910-483-4555",
            "fax_number": "910-483-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 DUNN RD",
            "city": "EASTOVER",
            "state": "NC",
            "postal_code": "283128794",
            "telephone_number": "910-483-4555",
            "fax_number": "910-483-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTOVER DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-22",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "910-483-4555"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10486",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266477",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3418541",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastover Drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastover Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eastover, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.