Tall Oaks Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

09273 Issued in NC

Legal business name

TALL OAKS PHARMACY

Practice address

798 Oak Ridge Farm Hwy
Ste C
Mooresville, NC 28115-7923

Phone

(704) 658-9814

Fax

(704) 658-0721

NPI assigned

Jul 14, 2006

Organization subpart

No

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

Authorized official

Name

Larry Carruth, RPHNPI 1073701561

Title

Owner

Phone

(704) 658-9814

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TALL OAKS PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry David Carruth Jr., R.PH.

  • Pharmacist
  • Mooresville, NC
  • NPI 1073701561
  NPD (past) Authorized official

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1366468225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 STUDLEY RD STE B",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162016",
            "telephone_number": "704-658-9814",
            "fax_number": "704-658-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 OAK RIDGE FARM HWY",
            "address_2": "STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281157923",
            "telephone_number": "704-658-9814",
            "fax_number": "704-658-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALL OAKS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "CARRUTH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-658-9814",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497529",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3405520",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TALL OAKS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carly Szymanski, PA-C
• Tadrissi DDS
• Ras-Solomon Tafari, LCSW-A
• Tailored Connections Pediatric Therapy, PLLC
• Tall Oaks Family Practice
• Swathi Talla, MD
• Adriana Tallman, OTR/L
• Megan Nicole Talluto, LCMHCA
• Devina Talwar, M.D.
• Daveisha Mercedes Tanck, LCSWA

• Community/Retail Pharmacy in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.