Kerr Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6512 Issued in NC

Legal business name

KERR DRUG INC

Practice address

140 NC Hwy 102 West
Ayden, NC 28513

Phone

(252) 746-3026

Fax

(252) 746-7953

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Mark Gregory, RPH

Title

VP of Pharmacy

Phone

(919) 544-3896

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• KERR DRUG Doing business as

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1376653071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162822",
            "telephone_number": "919-544-3896",
            "fax_number": "919-544-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NC HWY 102 WEST",
            "city": "AYDEN",
            "state": "NC",
            "postal_code": "28513",
            "telephone_number": "252-746-3026",
            "fax_number": "252-746-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERR DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "919-544-3896",
        "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": "6512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0745760",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3433935",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KERR DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Kiera Diamond Mamie Johnson, MS, LCMHCA, LCASA
• Cilicia Natasha Jones
• Wendi Dawn Jones, PHARMD, RPH
• Kaleo Support, Inc.
• Kerr Drug
• Andrea Lugo
• Luvkush LLC
• Luvkush LLC
• Jessica Lidieth Mairena
• Marys Care

• All providers in Ayden, NC
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.