Professional Pharmacy Concepts

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

09336 Issued in NC

Legal business name

PROFESSIONAL PHARMACY CONCEPTS

Practice address

120 Southpark Dr
Ste 402
Mooresville, NC 28117-8957

Phone

(704) 664-9528

Fax

(704) 746-3159

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Carel Vandyk, RPH

Title

Owner

Phone

(704) 664-9528

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205925856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SOUTHPARK DR",
            "address_2": "STE 402",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTHPARK DR",
            "address_2": "STE 402",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178957",
            "telephone_number": "704-664-9528",
            "fax_number": "704-746-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY CONCEPTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDYK",
        "authorized_official_first_name": "CAREL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-664-9528",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3407194",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.