NPIMap

Organization Active NPI

Go Pharmacy, Inc

  • Durable Medical Equipment & Medical Supplies
  • Lake Waccamaw, NC
National Provider Identifier
1386980449
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
11203 Issued in NC
Legal business name
GO PHARMACY, INC
Practice address
203 Chauncey Town Rd
Suite a
Lake Waccamaw, NC 28450-2003
Phone
(910) 646-6614
Fax
(910) 646-6615
NPI assigned
Dec 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Mr. Brenton Blake Byrd
Title
Ceo
Phone
(910) 646-6614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 11203 NC Primary

Addresses

Primary practice location

203 Chauncey Town Rd
Suite a
Lake Waccamaw, NC 28450-2003

Mailing address

PO Box 479
Lake Waccamaw, NC 28450-0479

National Provider Directory

National Provider Directory
Tax ID family
Go Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

203 Chauncey Town Rd
Ste A
Lake Waccamaw, NC 28450
Phone (910) 646-6614

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1386980449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284500479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 CHAUNCEY TOWN RD",
            "address_2": "SUITE A",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284502003",
            "telephone_number": "910-646-6614",
            "fax_number": "910-646-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GO PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "BRENTON",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-646-6614",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "11203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Waccamaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.