NPIMap

Organization Active NPI

Mast Drug Co Inc

Doing business as Mast Family Drug

  • Community/Retail Pharmacy
  • Henderson, NC
National Provider Identifier
1235205873
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
01735 Issued in NC
Legal business name
MAST DRUG CO INC
Doing business as
Mast Family Drug
Practice address
418 Dabney Dr
Henderson, NC 27536-3944
Phone
(252) 438-4158
Fax
(252) 438-7183
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Richard I Flye Jr.
Title
President
Phone
(252) 438-3112

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 01735 NC Primary

Addresses

Primary practice location

418 Dabney Dr
Henderson, NC 27536-3944

Mailing address

805 S Garnett St
Henderson, NC 27536
Phone (252) 438-3112

Other identifiers 4

IdentifierTypeStateIssuer
0915397MedicaidNC
2065974OtherPK
1235205873MedicaidNC
7700133MedicaidNC

Other names 1

  • MAST FAMILY DRUG Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051012000146 NC Part B Supplier - Mass Immunization (Roster Biller Only) 0648295345 3 other NPIs on this enrollment
Practice locations: Henderson, NC; Williamston, NC

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mast Drug Co Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

112 E Main St
Ste B
Williamston, NC 27892
Phone (252) 792-1772

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1235205873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S GARNETT ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "27536",
            "telephone_number": "252-438-3112",
            "fax_number": "252-492-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 DABNEY DR",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275363944",
            "telephone_number": "252-438-4158",
            "fax_number": "252-438-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAST DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "FLYE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-438-3112",
        "authorized_official_name_suffix": "Jr."
    },
    "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": "01735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0915397",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065974",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235205873",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700133",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAST FAMILY DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAST FAMILY DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.