Active NPI
Jerrell Stephen Bedford Jr., R.PH.
- Pharmacist
- Forest City, NC
National Provider Identifier
1376881326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8382
- Practice address
- 756 S Church St
Forest City, NC 28043-3941 - Phone
- (828) 245-0786
- Fax
- (828) 245-5509
- NPI assigned
- Jan 25, 2013
- Last updated
- Jan 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8382 | NC | Primary |
| Pharmacist | 183500000X | PH9255 | SC | |
| Pharmacist | 183500000X | RPH019099 | GA |
Addresses
Primary practice location
756 S Church St
Forest City, NC 28043-3941
Mailing address
756 S Church St
Forest City, NC 28043-3941
Phone (828) 245-0786
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH019099 | GA | MD | Pharmacist |
| PH9255 | SC | MD | Pharmacist |
| 8382 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ingles Markets Inc | Past | Accepting new patients | |
| Ingles Markets Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ingles Pharmacy #027
- Community/Retail Pharmacy
- Forest City, NC
- NPI 1750396602
-
- Community/Retail Pharmacy
- Acworth, GA
- NPI 1023872108
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359072000000",
"number": "1376881326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "756 S CHURCH ST",
"city": "FOREST CITY",
"state": "NC",
"postal_code": "280433941",
"telephone_number": "828-245-0786",
"fax_number": "828-245-5509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "756 S CHURCH ST",
"city": "FOREST CITY",
"state": "NC",
"postal_code": "280433941",
"telephone_number": "828-245-0786",
"fax_number": "828-245-5509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDFORD",
"first_name": "JERRELL",
"middle_name": "STEPHEN",
"name_suffix": "Jr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-25",
"last_updated": "2013-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "8382",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "PH9255",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH019099",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.