Organization Active NPI

Gate City Pharmacy Inc

Doing business as Gate City Pharmacy

  • Community/Retail Pharmacy
  • Greensboro, NC
National Provider Identifier
1407843584
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10415 Issued in NC
Legal business name
GATE CITY PHARMACY INC
Doing business as
Gate City Pharmacy
Practice address
803 Friendly Center Rd Ste C
Greensboro, NC 27408-2024
Phone
(336) 292-6888
Fax
(336) 294-9329
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Michael SkertichNPI 1457359960
Title
Buyer
Phone
(336) 292-6888

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 10415 NC Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

803 Friendly Center Rd Ste C
Greensboro, NC 27408-2024

Mailing address

803 Friendly Center Rd Ste C
Greensboro, NC 27408-2024
Phone (336) 292-6888

Other identifiers 3

IdentifierTypeStateIssuer
0415133MedicaidNC
7700707MedicaidNC
2122643OtherPK

Other names 1

  • Gate City Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180904002046 NC Part B Supplier - Pharmacy 9638295371 Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Locations

803 Friendly Center Rd
Ste C
Greensboro, NC 27408
Phone (336) 292-6888

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1407843584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 FRIENDLY CENTER RD STE C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082024",
            "telephone_number": "336-292-6888",
            "fax_number": "336-294-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 FRIENDLY CENTER RD STE C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082024",
            "telephone_number": "336-292-6888",
            "fax_number": "336-294-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATE CITY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "SKERTICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "BUYER",
        "authorized_official_telephone_number": "336-292-6888"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10415",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0415133",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700707",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2122643",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gate City Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.