North Village Pharmacy Inc

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

Organization subpart

No

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.

Title

Staff Pharmacist

Phone

(336) 694-4104

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC4 enrollments

Enrollment records 4

Tax ID family

North Village Pharmacy Inc3 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.

• North Village Pharmacy Inc

  • Long Term Care Pharmacy
  • Yanceyville, NC
  • NPI 1467917039
  NPD tax ID
• North Village Pharmacy, Inc

  • Community/Retail Pharmacy
  • Yanceyville, NC
  • NPI 1013162312
  NPD tax ID

Practitioners 2

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

• Adam W Evans, PHARMD

  • Pharmacist
  • Yanceyville, NC
  • NPI 1184102428
  NPD (past)
• Hubert Vernon Massengill Jr.

  • Pharmacist
  • Yanceyville, NC
  • NPI 1922565258
  NPD (past)

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175125",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700850",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mildred Blackwell
• Mildreds Family Care,Inc.
• James Millner III, PHARM D
• Frederick Ernest Moore, M.D.
• Christal De-Anna Nelson
• North Village Pharmacy Inc
• North Village Pharmacy, Inc
• Operation Boot Straps
• Kathy Lynn Patterson, FNP
• Patty Vision Center OD PA

• All providers in Yanceyville, NC
• Community/Retail Pharmacy in North Carolina

• 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.