NPIMap

Organization Active NPI

The Moses H. Cone Memorial Hospital Operating Corporation

Doing business as Wesley Long Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Greensboro, NC
National Provider Identifier
1386904886
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
11254 Issued in NC
Legal business name
THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Doing business as
Wesley Long Outpatient Pharmacy
Practice address
515 N Elam Ave
Greensboro, NC 27403-1118
Phone
(336) 218-5762
Fax
(336) 218-5763
NPI assigned
May 18, 2012
Last updated
May 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Authorized official

Name
Andy Starkey, BS PHARM
Title
Manager
Phone
(336) 632-4794

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 11254 NC Primary
Institutional Pharmacy 3336I0012X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

515 N Elam Ave
Greensboro, NC 27403-1118

Mailing address

515 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 218-5762

Other identifiers 2

IdentifierTypeStateIssuer
2135175OtherPK
0347907MedicaidNC

Other names 1

  • Wesley Long Outpatient Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130522000385 NC Part B Supplier - Pharmacy 6204744600 7 other NPIs on this enrollment
Practice locations: Asheboro, NC; Eden, NC; Greensboro, NC; High Point, NC

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Moses Cone Fam Prac Ctr41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Locations

515 N Elam Ave
Greensboro, NC 27403
Phone (336) 218-5762

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alamance Regional Medical Center IncBurlington, NC, CCN 34S070 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1386904886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N ELAM AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031118",
            "telephone_number": "336-218-5762",
            "fax_number": "336-218-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N ELAM AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031118",
            "telephone_number": "336-218-5762",
            "fax_number": "336-218-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "STARKEY",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "336-632-4794",
        "authorized_official_credential": "BS PHARM"
    },
    "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": "11254",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135175",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347907",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesley Long Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wesley Long Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.