Organization Active NPI

Valley Discount Pharmacy Incorporated

  • Pharmacy
  • Fayetteville, NC
National Provider Identifier
1417336686
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
22109 Issued in NC
Legal business name
VALLEY DISCOUNT PHARMACY INCORPORATED
Practice address
317 Owen Dr
Fayetteville, NC 28304-3429
Phone
(910) 630-6653
NPI assigned
May 21, 2015
Last updated
Sep 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Authorized official

Name
Anozie Nebolisa
Title
President
Phone
(910) 286-5905

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 22109 NC Primary

Addresses

Primary practice location

317 Owen Dr
Fayetteville, NC 28304-3429

Mailing address

1854 Geiberger Dr
Fayetteville, NC 28303-6224
Phone (910) 630-6653

National Provider Directory

National Provider Directory

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": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1417336686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1854 GEIBERGER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283036224",
            "telephone_number": "910-630-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043429",
            "telephone_number": "910-630-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY DISCOUNT PHARMACY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "NEBOLISA",
        "authorized_official_first_name": "ANOZIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-286-5905"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "22109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.