NPIMap

Organization Active NPI

Tri County Community Health Council Inc

  • Community/Retail Pharmacy
  • Tar Heel, NC
National Provider Identifier
1295903656
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10010 Issued in NC
Legal business name
TRI COUNTY COMMUNITY HEALTH COUNCIL INC
Practice address
16526 NC Highway 87 W
Tar Heel, NC 28392-8608
Phone
(910) 872-5720
Fax
(910) 872-3711
NPI assigned
Feb 19, 2008
Last updated
Jan 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Authorized official

Name
Chasity Hargrove, PHARMD
Title
Dir of Pharmacy
Phone
(910) 567-7119

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 10010 NC Primary

Addresses

Primary practice location

16526 NC Highway 87 W
Tar Heel, NC 28392-8608

Mailing address

16526 NC Highway 87 W
Tar Heel, NC 28392-8608
Phone (910) 872-5722

Other identifiers 2

IdentifierTypeStateIssuer
344001BMedicaidNC
3410494OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200616000785 NC Part B Supplier - Pharmacy 2163409558 1 other NPI on this enrollment
Practice locations: Dunn, NC; Tar Heel, NC

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Carolina Oaks Family Health25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1295903656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16526 NC HIGHWAY 87 W",
            "city": "TAR HEEL",
            "state": "NC",
            "postal_code": "283928608",
            "telephone_number": "910-872-5722",
            "fax_number": "910-872-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16526 NC HIGHWAY 87 W",
            "city": "TAR HEEL",
            "state": "NC",
            "postal_code": "283928608",
            "telephone_number": "910-872-5720",
            "fax_number": "910-872-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY COMMUNITY HEALTH COUNCIL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "HARGROVE",
        "authorized_official_first_name": "CHASITY",
        "authorized_official_title_or_position": "DIR OF PHARMACY",
        "authorized_official_telephone_number": "910-567-7119",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344001B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3410494",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tar Heel, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.