Active NPI
Robert Dale Harrison, BSPHARM
- Pharmacist
- Kernersville, NC
National Provider Identifier
1245686591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11764
- Practice address
- 1601 Old Greensboro Rd
Ste B
Kernersville, NC 27284-6855 - Phone
- (844) 871-4773
- Fax
- (844) 871-4776
- NPI assigned
- May 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11764 | NC | Primary |
| Pharmacist | 183500000X | 18417 | AL | |
| Pharmacist | 183500000X | S021155 | AZ | |
| Pharmacist | 183500000X | PD13115 | AR | |
| Pharmacist | 183500000X | PS 38395 | FL | |
| Pharmacist | 183500000X | PH 3848 | HI | |
| Pharmacist | 183500000X | P7238 | ID | |
| Pharmacist | 183500000X | 17505 | KY | |
| Pharmacist | 183500000X | PST.020979 | LA | |
| Pharmacist | 183500000X | 23042 | MD | |
| Pharmacist | 183500000X | P13841 | MS | |
| Pharmacist | 183500000X | 14811 | NE | |
| Pharmacist | 183500000X | R2575 | NH | |
| Pharmacist | 183500000X | RPH-0014572 | OR | |
| Pharmacist | 183500000X | 000038924 | TN |
Addresses
Primary practice location
1601 Old Greensboro Rd
Ste B
Kernersville, NC 27284-6855
Mailing address
1601 Old Greensboro Rd
Ste B
Kernersville, NC 27284-6855
Phone (844) 871-4773
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18417 | AL | MD | Pharmacist |
| PD13115 | AR | MD | Pharmacist |
| S021155 | AZ | MD | Pharmacist |
| PS 38395 | FL | MD | Pharmacist |
| PH 3848 | HI | MD | Pharmacist |
| P7238 | ID | MD | Pharmacist |
| 17505 | KY | MD | Pharmacist |
| PST.020979 | LA | MD | Pharmacist |
| 23042 | MD | MD | Pharmacist |
| P13841 | MS | MD | Pharmacist |
| 11764 | NC | MD | Pharmacist |
| 14811 | NE | MD | Pharmacist |
| R2575 | NH | MD | Pharmacist |
| RPH-0014572 | OR | MD | Pharmacist |
| 000038924 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nufactor, Inc. | Past | Accepting new patients | |
| Nufactor Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Infusion Therapy Pharmacy
- Kernersville, NC
- NPI 1093112336
-
- Home Infusion Therapy Pharmacy
- Ronkonkoma, NY
- NPI 1083325518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462406400000",
"number": "1245686591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 OLD GREENSBORO RD",
"address_2": "STE B",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272846855",
"telephone_number": "844-871-4773",
"fax_number": "844-871-4776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 OLD GREENSBORO RD",
"address_2": "STE B",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272846855",
"telephone_number": "844-871-4773",
"fax_number": "844-871-4776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "ROBERT",
"middle_name": "DALE",
"credential": "BSPHARM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-05",
"last_updated": "2016-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "11764",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "18417",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S021155",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD13115",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 38395",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH 3848",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P7238",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "17505",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.020979",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "23042",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "P13841",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "14811",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "R2575",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0014572",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "000038924",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.