The Hawthorne Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

NC06232 Issued in NC

Legal business name

THE HAWTHORNE PHARMACY LLC

Practice address

1622 South Hawthorne Road
Winston-Salem, NC 27103-4103

Phone

(336) 768-1815

Fax

(336) 768-0518

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Amy M White, RPH

Title

Manager

Phone

(336) 768-1815

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366472292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 SOUTH HAWTHORNE ROAD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034103",
            "telephone_number": "336-768-1815",
            "fax_number": "336-768-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 SOUTH HAWTHORNE ROAD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034103",
            "telephone_number": "336-768-1815",
            "fax_number": "336-768-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HAWTHORNE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "336-768-1815",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "NC06232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC0346957",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Winston-Salem, NC
• Pharmacy 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.