Edc Drug Stores Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8647 Issued in NC

Legal business name

EDC DRUG STORES INC

Doing business as

Rite Aid Pharmacy 11375

Practice address

806 East Ash Street
Goldsboro, NC 27530-3804

Phone

(919) 734-3121

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer M Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• RITE AID PHARMACY 11375 Doing business as

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Ann Bryant Coats, PHARMD

  • Pharmacist
  • Goldsboro, NC
  • NPI 1043592348
  NPD (past)
• Joan Grant-Chin, PHARM D

  • Pharmacist
  • Goldsboro, NC
  • NPI 1285926147
  NPD (past)
• Kelly Michelle Pate, PHARMD

  • Pharmacist
  • Fayetteville, NC
  • NPI 1982087870
  NPD (past)
• John Wade Williamson, PHARMD

  • Pharmacist
  • Goldsboro, NC
  • NPI 1922306422
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1174622377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWBERRY COMMONS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-761-2633",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 EAST ASH STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303804",
            "telephone_number": "919-734-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDC DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "8647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0965573",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "7702324",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3402485",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 11375",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adrienne Eby, CRNA
• Eckerd Corporation (Rite Aid Pharmacy 11377)
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• Ronnie Elaine Edmundson, NP
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• Candra Nikita Edwards
• Shana Edwards, CRNA

• Community/Retail Pharmacy in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.