NPIMap

Organization Active NPI

Tom Lamartina Inc

  • Community/Retail Pharmacy
  • Brookneal, VA
National Provider Identifier
1174610083
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TOM LAMARTINA INC
Practice address
120 Rush St W
Brookneal, VA 24528-3026
Phone
(434) 376-2220
Fax
(434) 376-2220
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Dr. Nathan Payne, PHARMDNPI 1891076154
Title
Pic/Owner
Phone
(434) 376-2220

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 0201000073 VA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

120 Rush St W
Brookneal, VA 24528-3026

Mailing address

PO Box 66
Brookneal, VA 24528-0066
Phone (434) 376-2220

Other identifiers 2

IdentifierTypeStateIssuer
8502803MedicaidVA
4805151OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140919001336 VA Part B Supplier - Pharmacy 6507081429 Practice locations: Brookneal, VA
O20210208001311 VA Part B Supplier - Mass Immunization (Roster Biller Only) 6507081429 Practice locations: Brookneal, VA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1174610083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "BROOKNEAL",
            "state": "VA",
            "postal_code": "245280066",
            "telephone_number": "434-376-2220",
            "fax_number": "434-376-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RUSH ST W",
            "city": "BROOKNEAL",
            "state": "VA",
            "postal_code": "245283026",
            "telephone_number": "434-376-2220",
            "fax_number": "434-376-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM LAMARTINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-01-21",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "PIC/OWNER",
        "authorized_official_telephone_number": "434-376-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201000073",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8502803",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4805151",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookneal, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.