Street Drug Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201002833 Issued in VA

Legal business name

STREET DRUG CORPORATION

Practice address

110 W Main St
Lebanon, VA 24266-4214

Phone

(276) 889-1919

Fax

(276) 889-4635

NPI assigned

Nov 14, 2005

Organization subpart

No

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

Authorized official

Name

Ralph Street, RPHNPI 1164407177

Title

VP Pharmacy

Phone

(276) 889-1919

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• FAMILY DRUG CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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

• Ralph Lee Street, RPH

  • Pharmacist
  • Lebanon, VA
  • NPI 1164407177
  NPD Authorized official
• Jared Street

  • Pharmacist
  • Lebanon, VA
  • NPI 1306598651
  NPD
• Nellie C Street, RPH

  • Pharmacist
  • Lebanon, VA
  • NPI 1679650352
  NPD (past)

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1477534709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664214",
            "telephone_number": "276-889-1919",
            "fax_number": "276-889-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664214",
            "telephone_number": "276-889-1919",
            "fax_number": "276-889-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREET DRUG CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "VP PHARMACY",
        "authorized_official_telephone_number": "276-889-1919",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201002833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008531315",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2104077",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY DRUG CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Stacy
• Charles Seth Stanley, PT, DPT
• Steve Ball DDS PC
• Mandy Stiltner, RPH
• Jessica Stone, MS, CCC-SLP
• Jared Street
• Jocelyn Street
• Nellie C Street, RPH
• Ralph Lee Street, RPH
• Susan B Humphreys MD PC

• Community/Retail Pharmacy in Lebanon, VA
• Providers in Lebanon, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.