Organization Active NPI

Marley Drug Inc

  • Community/Retail Pharmacy
  • Winston Salem, NC
National Provider Identifier
1376640201
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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

Updated by the provider on Jan 19, 2021

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0347123MedicaidNC
2069685OtherPK

Other names 1

  • MARLEY DRUG INC Doing business as

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.