Active NPI
Devin Olden
- Pharmacist
- Pembroke, NC
National Provider Identifier
1336962729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 33539
- Practice address
- 930 NC-711
Pembroke, NC 28372 - Phone
- (910) 522-5250
- NPI assigned
- Nov 4, 2024
- Last updated
- Nov 4, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 33539 | NC | Primary |
Addresses
Primary practice location
930 NC-711
Pembroke, NC 28372
Mailing address
6403 Gatwick Rd
Fayetteville, NC 28311-2980
Phone (910) 308-3298
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33539 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1336962729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6403 GATWICK RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283112980",
"telephone_number": "910-308-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 NC-711",
"city": "PEMBROKE",
"state": "NC",
"postal_code": "28372",
"telephone_number": "910-522-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLDEN",
"first_name": "DEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-04",
"last_updated": "2024-11-04",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "33539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.