Medtech Pharmacy, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

12147 Issued in NC

Legal business name

MEDTECH PHARMACY, LLC

Practice address

426 Gallimore Dairy Rd Ste 100
Greensboro, NC 27409-9548

Phone

(336) 252-2640

Fax

(336) 285-7237

NPI assigned

Nov 18, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Martin Willing Jr., R.PH.

Title

Chief Operating Officer

Phone

(502) 423-7525

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1447656400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SHELBYVILLE RD",
            "address_2": "STE 2B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232937",
            "telephone_number": "502-423-7525",
            "fax_number": "502-425-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 GALLIMORE DAIRY RD STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099548",
            "telephone_number": "336-252-2640",
            "fax_number": "336-285-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTECH PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "WILLING",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "502-423-7525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "12147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447656400",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Long Term Care Pharmacy in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.