Organization Active NPI

Pruitthealth Pharmacy Services - Durham, Inc.

  • Community/Retail Pharmacy
  • Durham, NC
National Provider Identifier
1154897189
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PRUITTHEALTH PHARMACY SERVICES - DURHAM, INC.
Practice address
4024 Stirrup Creek Drive
Suite 120
Durham, NC 27703-8971
Phone
(800) 390-2906
Fax
(919) 484-9009
NPI assigned
Oct 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Neil L. Pruitt Jr.
Title
Chairman and Ceo
Phone
(770) 279-6200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4024 Stirrup Creek Drive
Suite 120
Durham, NC 27703-8971

Mailing address

1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (678) 533-6382

Other names 1

  • PruittHealth Pharmacy Services - Durham Doing business as

National Provider Directory

National Provider Directory

Locations

4022 Stirrup Creek Dr
Ste 325
Durham, NC 27703
Phone (800) 390-2905

Practitioners & affiliated clinicians

Practitioners 1

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": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1154897189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "678-533-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 STIRRUP CREEK DRIVE",
            "address_2": "SUITE 120",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277038971",
            "telephone_number": "800-390-2906",
            "fax_number": "919-484-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH PHARMACY SERVICES - DURHAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Pharmacy Services - Durham",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth Pharmacy Services - Durham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.