NPIMap

Organization Active NPI

CMC-Northeast, Inc.

  • Community/Retail Pharmacy
  • Concord, NC
National Provider Identifier
1376798678
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
09822 Issued in NC
Legal business name
CMC-NORTHEAST, INC.
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 403-2079
NPI assigned
Dec 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Evan S Frasure III, PHARMD
Title
Manager, Outpatient Pharmacy Servic
Phone
(704) 403-2079

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 09822 NC Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

920 Church St N
Concord, NC 28025-2927

Other identifiers 1

IdentifierTypeStateIssuer
1376579052OtherNPI

Other names 1

  • Pavilion Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
CMC Northeast44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1376798678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927"
        },
        {
            "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": "280252927",
            "telephone_number": "704-403-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMC-NORTHEAST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FRASURE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER, OUTPATIENT PHARMACY SERVIC",
        "authorized_official_telephone_number": "704-403-2079",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376579052",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pavilion Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 7, 2023; 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.