Organization Active NPI

Martin's Pharmacy of Rural Retreat Inc

  • Pharmacy
  • Rural Retreat, VA
National Provider Identifier
1346891918
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MARTIN'S PHARMACY OF RURAL RETREAT INC
Practice address
100 W Buck Ave
Rural Retreat, VA 24368-2515
Phone
(276) 250-2160
Fax
(276) 250-2184
NPI assigned
Sep 25, 2019
Last updated
Jun 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Authorized official

Name
Dr. William Hampton Hale, PHARM.D.
Title
Director of Corporation
Phone
(540) 230-4250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

100 W Buck Ave
Rural Retreat, VA 24368-2515

Mailing address

PO Box 699
Pulaski, VA 24301-0699
Phone (540) 230-4250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200630000088 VA Part B Supplier - Pharmacy 0840612396 Practice locations: Rural Retreat, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2249225Martin's Pharmacy of Rural Retreat Inc100 West Buck Ave, Rural Retreat, VA 24368Certificate of waiverJan 18, 2028

National Provider Directory

National Provider Directory

Locations

100 W Buck Ave
Rural Retreat, VA 24368
Phone (276) 250-2160

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": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1346891918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243010699",
            "telephone_number": "540-230-4250",
            "fax_number": "540-980-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W BUCK AVE",
            "city": "RURAL RETREAT",
            "state": "VA",
            "postal_code": "243682515",
            "telephone_number": "276-250-2160",
            "fax_number": "276-250-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN'S PHARMACY OF RURAL RETREAT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HAMPTON",
        "authorized_official_title_or_position": "DIRECTOR OF CORPORATION",
        "authorized_official_telephone_number": "540-230-4250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rural Retreat, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.