NPIMap

Organization Active NPI

Mast Drug Co Inc

  • Long Term Care Pharmacy
  • Clemmons, NC
National Provider Identifier
1306945480
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
05626 Issued in NC
Legal business name
MAST DRUG CO INC
Practice address
6000 Meadowbrook Mall CT
Ste 200
Clemmons, NC 27012-8112
Phone
(336) 712-0280
Fax
(336) 766-7208
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Authorized official

Name
Polly Beal
Title
Adm MGR
Phone
(252) 438-3112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 05626 NC Primary

Addresses

Primary practice location

6000 Meadowbrook Mall CT
Ste 200
Clemmons, NC 27012-8112

Mailing address

1910 Ross Mill Rd
Henderson, NC 27537-8789
Phone (252) 438-3112

Other identifiers 1

IdentifierTypeStateIssuer
3430725OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Mast Long Term Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mast Drug Co Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

6000 Meadowbrook Mall Ct
Ste 200
Clemmons, NC 27012
Phone (336) 712-0280

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292457600000",
    "number": "1306945480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROSS MILL RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275378789",
            "telephone_number": "252-438-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 MEADOWBROOK MALL CT",
            "address_2": "STE 200",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128112",
            "telephone_number": "336-712-0280",
            "fax_number": "336-766-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAST DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2010-12-16",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "ADM MGR",
        "authorized_official_telephone_number": "252-438-3112"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "05626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3430725",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mast Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.