Organization Active NPI

Garner 5TH Avenue Pharmacy Inc.

  • Community/Retail Pharmacy
  • Garner, NC
National Provider Identifier
1154961290
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GARNER 5TH AVENUE PHARMACY INC.
Practice address
1315 5TH Ave
Garner, NC 27529-3637
Phone
(919) 747-9482
NPI assigned
Jan 7, 2020
Last updated
Jun 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Mr. Thomas Howard Bunch, RPHNPI 1952600702
Title
President/RX MGR.
Phone
(919) 747-9482

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 1

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

Addresses

Primary practice location

1315 5TH Ave
Garner, NC 27529-3637

Mailing address

1315 5TH Ave
Garner, NC 27529-3637
Phone (919) 747-9482

Other identifiers 1

IdentifierTypeStateIssuer
873494MedicaidNC

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200608002202 NC Part B Supplier - Mass Immunization (Roster Biller Only) 6507287117 Practice locations: Garner, NC
O20200713000345 NC DME Supplier - Pharmacy 6507287117 Practice locations: Garner, NC

National Provider Directory

National Provider Directory

Locations

1315 5th Ave
Garner, NC 27529
Phone (919) 747-9482

Practitioners & affiliated clinicians

Practitioners 1

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": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1154961290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 5TH AVE",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293637",
            "telephone_number": "919-747-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 5TH AVE",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293637",
            "telephone_number": "919-747-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARNER 5TH AVENUE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "BUNCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT/RX MGR.",
        "authorized_official_telephone_number": "919-747-9482",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "873494",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.