NPIMap

Organization Active NPI

Triad Adult and Pediatric Medicine Inc

Doing business as Triad Adult and Pediatric Med - GCH Wendover Pharmacy

  • Community/Retail Pharmacy
  • Greensboro, NC
National Provider Identifier
1235483785
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
11385 Issued in NC
Legal business name
TRIAD ADULT AND PEDIATRIC MEDICINE INC
Doing business as
Triad Adult and Pediatric Med - GCH Wendover Pharmacy
Practice address
1046 E Wendover Ave
Greensboro, NC 27405-6712
Phone
(336) 355-9908
Fax
(336) 275-1033
NPI assigned
Nov 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Amy Hallisey
Title
Pharmacy Director
Phone
(336) 355-9908

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 11385 NC Primary

Addresses

Primary practice location

1046 E Wendover Ave
Greensboro, NC 27405-6712

Mailing address

1046 E Wendover Ave
Greensboro, NC 27405-6712
Phone (336) 355-9908

Other identifiers 2

IdentifierTypeStateIssuer
344047BMedicaidNC
2137806OtherPK

Other names 1

  • Triad Adult and Pediatric Med - GCH Wendover Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Triad Adult and Pediatric Medicine Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1235483785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056712",
            "telephone_number": "336-355-9908",
            "fax_number": "336-275-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056712",
            "telephone_number": "336-355-9908",
            "fax_number": "336-275-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD ADULT AND PEDIATRIC MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "HALLISEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "336-355-9908"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344047B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137806",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triad Adult and Pediatric Med - GCH Wendover Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.