Organization Active NPI

Lax Cotswold LLC

Doing business as Walker's Drug Store

  • Pharmacy
  • Charlotte, NC
National Provider Identifier
1396800710
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
12986 Issued in NC
Legal business name
LAX COTSWOLD LLC
Doing business as
Walker's Drug Store
Practice address
4390 Colwick Rd
Charlotte, NC 28211-2310
Phone
(704) 364-3444
Fax
(704) 364-1320
NPI assigned
Dec 26, 2006
Last updated
Apr 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Vipul PatelNPI 1720692288
Title
Owner
Phone
(704) 364-3444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 12986 NC Primary
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

4390 Colwick Rd
Charlotte, NC 28211-2310

Mailing address

4390 Colwick Rd
Charlotte, NC 28211-2310
Phone (704) 364-3444

Other identifiers 1

IdentifierTypeStateIssuer
2159592OtherPK

Other names 1

  • Walker's Drug Store Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190530000001 NC Part B Supplier - Pharmacy 4385987627 Practice locations: Charlotte, NC
O20210614001033 NC Part B Supplier - Independent Clinical Laboratory 4385987627 Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory
Tax ID family
Lax Cotswold LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

8145 Ardrey Kell Rd
Ste 105
Charlotte, NC 28277
Phone (704) 321-0027

Practitioners & affiliated clinicians

Practitioners 1

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": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1396800710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4390 COLWICK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112310",
            "telephone_number": "704-364-3444",
            "fax_number": "704-364-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 COLWICK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112310",
            "telephone_number": "704-364-3444",
            "fax_number": "704-364-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAX COTSWOLD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-364-3444"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "12986",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walker's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walker's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.