NPIMap

Organization Active NPI

CHS Pharmacy Services Inc

  • Community/Retail Pharmacy
  • Concord, NC
National Provider Identifier
1376579052
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12984 Issued in NC
Legal business name
CHS PHARMACY SERVICES INC
Practice address
920 Church St N
Concord, NC 28025
Phone
(704) 403-1568
Fax
(704) 403-1784
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Nicholas Cole Wilson
Title
Avp Pharmacy Services
Phone
(704) 446-1404

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 12984 NC Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

920 Church St N
Concord, NC 28025

Mailing address

PO Box 603216
Charlotte, NC 28260-3216
Phone (704) 512-7637

Other identifiers 2

IdentifierTypeStateIssuer
0135699MedicaidNC
2069332OtherPK

Other names 1

  • Atrium Health Pharmacy Pavilion Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160915000994 NC DME Supplier - Pharmacy 9830407972 Practice locations: Concord, NC
O20161005001843 NC Part B Supplier - Pharmacy 9830407972 2 other NPIs on this enrollment
Practice locations: Charlotte, NC; Concord, NC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
CHS Pharmacy Services Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1376579052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603216",
            "telephone_number": "704-512-7637",
            "fax_number": "704-512-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-403-1568",
            "fax_number": "704-403-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS PHARMACY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "COLE",
        "authorized_official_title_or_position": "AVP PHARMACY SERVICES",
        "authorized_official_telephone_number": "704-446-1404"
    },
    "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": "12984",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135699",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2069332",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atrium Health Pharmacy Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.