Active NPI
Marley Drug Inc
- Community/Retail Pharmacy
- Winston Salem, NC
National Provider Identifier
1376640201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MARLEY DRUG INC
- Practice address
- 5008 Peters Creek Pkwy
Winston Salem, NC 27127-7276 - Phone
- (336) 771-7672
- Fax
- (336) 771-9921
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James Kinley
- Title
- Officer of Marley Drug and Cfo
- Phone
- (204) 478-5604
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 08320 | NC | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
5008 Peters Creek Pkwy
Winston Salem, NC 27127-7276
Mailing address
5008 Peters Creek Pkwy
Winston Salem, NC 27127-7276
Phone (336) 771-7672
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0347123 | Medicaid | NC | |
| 2069685 | Other | PK |
Other names 1
- MARLEY DRUG INC
National Provider Directory
National Provider DirectoryLocations
5008 Peters Creek Pkwy
Winston Salem, NC 27127
Phone (336) 771-7672
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Winston Salem, NC
- NPI 1164720264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1611014400000",
"number": "1376640201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5008 PETERS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271277276",
"telephone_number": "336-771-7672",
"fax_number": "336-771-9921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5008 PETERS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271277276",
"telephone_number": "336-771-7672",
"fax_number": "336-771-9921"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARLEY DRUG INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A",
"authorized_official_last_name": "KINLEY",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "OFFICER OF MARLEY DRUG AND CFO",
"authorized_official_telephone_number": "204-478-5604",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NC",
"license": "08320",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0347123",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2069685",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MARLEY DRUG INC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "MARLEY DRUG INC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.