NPIMap

Organization Active NPI

Brogden Corporation

Doing business as Summerfield Pharmacy Immunization

  • Community/Retail Pharmacy
  • Summerfield, NC
National Provider Identifier
1285861310
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
08993 Issued in NC
Legal business name
BROGDEN CORPORATION
Doing business as
Summerfield Pharmacy Immunization
Practice address
4446 US Highway 220 N Ste C
Summerfield, NC 27358-9415
Phone
(336) 644-7058
Fax
(336) 644-7297
NPI assigned
Jun 16, 2009
Last updated
Jun 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Authorized official

Name
Mr. Harry Lee Brogden Jr., RPHNPI 1316172190
Title
Pharmacy Manager/President
Phone
(336) 644-7058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 08993 NC Primary

Addresses

Primary practice location

4446 US Highway 220 N Ste C
Summerfield, NC 27358-9415

Mailing address

4446 US Highway 220 N Ste C
Summerfield, NC 27358-9415
Phone (336) 644-7058

Other identifiers 2

IdentifierTypeStateIssuer
7704343OtherNCMEDICAID DME
0418181MedicaidNC

Other names 1

  • Summerfield Pharmacy Immunization Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brogden Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1285861310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4446 US HIGHWAY 220 N STE C",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589415",
            "telephone_number": "336-644-7058",
            "fax_number": "336-644-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4446 US HIGHWAY 220 N STE C",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589415",
            "telephone_number": "336-644-7058",
            "fax_number": "336-644-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROGDEN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "BROGDEN",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHARMACY MANAGER/PRESIDENT",
        "authorized_official_telephone_number": "336-644-7058",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "08993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "7704343",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418181",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summerfield Pharmacy Immunization",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.