Fayetteville Family Medical Care, PA

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

07787 Issued in NC

Legal business name

FAYETTEVILLE FAMILY MEDICAL CARE, PA

Practice address

1307 Avon St
Fayetteville, NC 28304-4423

Phone

(910) 323-1718

Fax

(910) 323-3834

NPI assigned

Mar 9, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Alice M Kugler

Title

Administrator

Phone

(910) 323-1718

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fayetteville Family Pharmacy Doing business as

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1265707228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-323-1718",
            "fax_number": "910-323-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-323-1718",
            "fax_number": "910-323-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE FAMILY MEDICAL CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "KUGLER",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-323-1718",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": "07787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "048YU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayetteville Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic Pharmacy in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinic Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.