Organization Active NPI

Food Lion LLC

  • Community/Retail Pharmacy
  • Falling Waters, WV
National Provider Identifier
1245514009
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FOOD LION LLC
Practice address
78 Worchester Drive
Falling Waters, WV 25419
Phone
(304) 271-8836
Fax
(304) 271-8839
NPI assigned
Sep 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Margaret M Ham
Title
President
Phone
(207) 885-7454

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

78 Worchester Drive
Falling Waters, WV 25419

Mailing address

PO Box 1000
Ms3000
Portland, ME 04104-5005
Phone (207) 885-7454

Other identifiers 2

IdentifierTypeStateIssuer
3810022093MedicaidWV
5055543OtherNCPDP PROVIDER NUMBER

Other names 1

  • Food Lion Pharmacy #2194 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120531000152 WV DME Supplier - PharmacyDME Supplier - Grocery Store 3971615923 Practice locations: Falling Waters, WV
O20150929003266 WV Part B Supplier - Mass Immunization (Roster Biller Only) 3971615923 Practice locations: Falling Waters, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Food Lion LLC78 Worchester Dr, Falling Waters, WV 25419-4998(304) 271-8836 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2005

National Provider Directory

National Provider Directory
Tax ID family
Food Lion LLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1245514009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "MS3000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045005",
            "telephone_number": "207-885-7454",
            "fax_number": "207-885-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 WORCHESTER DRIVE",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "25419",
            "telephone_number": "304-271-8836",
            "fax_number": "304-271-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOD LION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-885-7454"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022093",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER NUMBER",
            "identifier": "5055543",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Food Lion Pharmacy #2194",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falling Waters, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.