Iredell Drug Care Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

05610 Issued in NC

Legal business name

IREDELL DRUG CARE INC.

Practice address

3478 E Broad St
Statesville, NC 28625-4523

Phone

(704) 878-6681

Fax

(704) 878-6684

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Alan Grey Banner, R.PH.

Title

President

Phone

(704) 878-6681

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• banner drug co. Doing business as

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356491823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3478 E BROAD ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254523",
            "telephone_number": "704-878-6681",
            "fax_number": "704-878-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3478 E BROAD ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254523",
            "telephone_number": "704-878-6681",
            "fax_number": "704-878-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IREDELL DRUG CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANNER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "GREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-878-6681",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "05610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0496471",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "banner drug co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Iredell County DSS
• Iredell County DSS
• Iredell County Group Services, PLLC
• Iredell County Health Department
• Iredell County Rescue Squad Inc
• Iredell Drug Care, Inc
• Iredell Head, Neck and Ear Ambulatory Surgery Center, Inc.
• Iredell Mem Hospital Cap Program
• Iredell Memorial Hosp SNF Icf
• Iredell Memorial Hospital Incorporated

• Pharmacist in Statesville, NC
• Providers in Statesville, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.