Organization Active NPI

Charlotte Drug Company

  • Community/Retail Pharmacy
  • Charlotte C H, VA
National Provider Identifier
1386728806
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CHARLOTTE DRUG COMPANY
Doing business as
Charlotte Drug Company
Practice address
120 David Bruce Ave
Charlotte C H, VA 23923-0728
Phone
(434) 542-5171
Fax
(434) 542-5809
NPI assigned
Oct 24, 2006
Last updated
Nov 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Authorized official

Name
Mrs. Shawna Jones, PHARM DNPI 1629469457
Title
Owner
Phone
(434) 542-5171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

120 David Bruce Ave
Charlotte C H, VA 23923-0728

Mailing address

PO Box 728
Charlotte Court House, VA 23923-0728
Phone (434) 542-5171

Other identifiers 2

IdentifierTypeStateIssuer
009106308MedicaidVA
118025OtherBCBS OF VA

Other names 1

  • CHARLOTTE DRUG COMPANY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111122000484 VA Part B Supplier - Mass Immunization (Roster Biller Only) 0840301990 Practice locations: Charlotte Court House, VA

National Provider Directory

National Provider Directory

Locations

120 David Bruce Ave
Charlotte Court House, VA 23923
Phone (434) 542-5171

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1386728806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "CHARLOTTE COURT HOUSE",
            "state": "VA",
            "postal_code": "239230728",
            "telephone_number": "434-542-5171",
            "fax_number": "434-542-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DAVID BRUCE AVE",
            "city": "CHARLOTTE C H",
            "state": "VA",
            "postal_code": "239230728",
            "telephone_number": "434-542-5171",
            "fax_number": "434-542-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-542-5171",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009106308",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF VA",
            "identifier": "118025",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHARLOTTE DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHARLOTTE DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte C H, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.