CCRX of North Carolina, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

CCRX OF NORTH CAROLINA, LLC

Doing business as

Omnicare of Raleigh #48294

Practice address

1815 Garner Station Blvd
Raleigh, NC 27603-3644

Phone

(919) 834-1600

Fax

(919) 834-5644

NPI assigned

Dec 28, 2006

Last updated

Sep 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Colbert

Title

Sr Director, Payer Relations

Phone

(401) 770-2751

Specialties & licenses 1

Addresses

Other names 1

• Omnicare of Raleigh #48294 Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc.

  dba CVS Pharmacy #17247

  • Pharmacy
  • North Dartmouth, MA
  • NPI 1831271071

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Kristy Lynn Simpson, PHARM.D

  • Pharmacist
  • Raleigh, NC
  • NPI 1750988622
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1205992948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 GARNER STATION BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033644",
            "telephone_number": "919-834-1600",
            "fax_number": "919-834-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRX OF NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Omnicare of Raleigh #48294",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayla Caulk
• Kimberly Caulway, MD
• Michelle Lynn Causey, CRNA
• Stephen Robert Cavitt, PHYSICAL THERAPIST
• Cameron Frank Cavola, D.M.D., M.D.
• CDH Enterprise LLC
• Cdo Foot Solutions Raleigh, Inc. (Foot Solutions of Raleigh)
• Megan Kathleen Cebina I, PT,MA
• Amina Cebo
• Danielle Nicole Cecil, CRNA

• Long Term Care Pharmacy in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.