The Drug Store Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

12913 Issued in NC

Legal business name

THE DRUG STORE INC

Doing business as

Legacy Consultant Pharmacy

Practice address

3064 Salem Industrial Dr
Winston Salem, NC 27127-8854

Phone

(336) 831-0500

Fax

(855) 760-7126

NPI assigned

Jun 21, 2006

Last updated

May 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darrell Holland

Title

Executive Manager

Phone

(888) 729-0729

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• LEGACY CONSULTANT PHARMACY Doing business as

Locations

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.

• Mary C Thomas, RPH, CGP, FSACP

  • Pharmacist
  • Winston Salem, NC
  • NPI 1013999689
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1285670174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3064 SALEM INDUSTRIAL DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278854",
            "telephone_number": "336-831-0500",
            "fax_number": "855-760-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 SALEM INDUSTRIAL DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278854",
            "telephone_number": "336-831-0500",
            "fax_number": "855-760-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "888-729-0729"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "12913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347064",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2069115",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8519412",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEGACY CONSULTANT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Long Term Care Pharmacy in North Carolina

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

Verify at the official NPI Registry.