NPIMap

Organization Active NPI

North Village Pharmacy Inc

  • Community/Retail Pharmacy
  • Yanceyville, NC
National Provider Identifier
1194744342
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
3238 Issued in NC
Legal business name
NORTH VILLAGE PHARMACY INC
Practice address
1493 Main St
Yanceyville, NC 27379-8793
Phone
(336) 694-4104
Fax
(336) 694-5823
NPI assigned
Jul 19, 2006
Last updated
Jun 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Dr. James B Millner III, PHARM.D., R.PH.NPI 1154855302
Title
Staff Pharmacist
Phone
(336) 694-4104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 3238 NC Primary

Addresses

Primary practice location

1493 Main St
Yanceyville, NC 27379-8793

Mailing address

PO Box 1209
1493 Main Street
Yanceyville, NC 27379-1209
Phone (336) 694-4104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20071009000284 NC Part B Supplier - Mass Immunization (Roster Biller Only) 3577658327 Practice locations: Yanceyville, NC
O20100930039461 NC DME Supplier - Pharmacy 3577658327 Practice locations: Yanceyville, NC
O20200617001390 NC Part B Supplier - Pharmacy 3577658327 Practice locations: Yanceyville, NC
O20210106002111 NC Part B Supplier - Independent Clinical Laboratory 3577658327 Practice locations: Yanceyville, NC

National Provider Directory

National Provider Directory
Tax ID family
North Village Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1194744342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "address_2": "1493 MAIN STREET",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273791209",
            "telephone_number": "336-694-4104",
            "fax_number": "336-694-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 MAIN ST",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798793",
            "telephone_number": "336-694-4104",
            "fax_number": "336-694-5823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "MILLNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "336-694-4104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHARM.D., R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "3238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yanceyville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.