Ebp LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12534 Issued in NC

Legal business name

EBP LLC

Practice address

300 Main Ave W
Hildebran, NC 28637-8315

Phone

(828) 397-3420

Fax

(828) 397-3477

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Spencer W Hodges, PHARMD

Title

Vice President

Phone

(828) 264-3055

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EAST BURKE PHARMACY, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Ebp LLC

  • Pharmacy
  • Hildebran, NC
  • NPI 1861851859

  8628383718

  Same PAC ID

Tax ID family

East Burke Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ebp LLC

  • Pharmacy
  • Hildebran, NC
  • NPI 1861851859
  NPD tax ID

Practitioners 2

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

• Leigh Anne Abernathy

  • Pharmacist
  • Hildebran, NC
  • NPI 1811140098
  NPD (past)
• Jennifer Stewart Kistler, PHARM.D.

  • Pharmacist
  • Hildebran, NC
  • NPI 1851652200
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1215042536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 DEERFIELD RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075009",
            "telephone_number": "828-355-3365",
            "fax_number": "828-264-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN AVE W",
            "city": "HILDEBRAN",
            "state": "NC",
            "postal_code": "286378315",
            "telephone_number": "828-397-3420",
            "fax_number": "828-397-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "828-264-3055",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150943",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST BURKE PHARMACY, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesse Rey Nobleza Consing, M.D
• Victoria Shelton Craig, PT, DPT
• Holly Dula, OTR/L
• East Burke Pharmacy
• East Burke Pharmacy Inc.
• Ebp LLC
• John Michael Fish, DDS
• Judith Morgan Goodman, RPH
• Donna Hatcher
• Michael Herrell, PHARMD

• Community/Retail Pharmacy in Hildebran, NC
• Providers in Hildebran, 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 Mar 7, 2025; 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.