NPIMap

Organization Active NPI

Medical Center Pharmacy of Wilmington, LLC

  • Community/Retail Pharmacy
  • Wilmington, NC
National Provider Identifier
1477611663
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5247 Issued in NC
Legal business name
MEDICAL CENTER PHARMACY OF WILMINGTON, LLC
Practice address
912 S 16TH St
Wilmington, NC 28401-8016
Phone
(910) 763-1896
Fax
(910) 763-1709
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Austin Murphy
Title
VP/Manager/Secretary
Phone
(305) 808-9838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5247 NC Primary

Addresses

Primary practice location

912 S 16TH St
Wilmington, NC 28401-8016

Mailing address

912 S 16TH St
Wilmington, NC 28401-8016
Phone (910) 763-1896

Other identifiers 3

IdentifierTypeStateIssuer
7700605MedicaidNC
0405KOtherNCBCBS NC PROVIDER #
0655753MedicaidNC

Other names 2

  • Medical Center Specialty Pharmacy Doing business as
  • Medical Center Pharmacy of Wilmington, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080125000202 NC Part B Supplier - Mass Immunization (Roster Biller Only) 9931281243 Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

912 S 16th St
Wilmington, NC 28401
Phone (910) 763-1896

Practitioners & affiliated clinicians

Practitioners 5

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1477611663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284018016",
            "telephone_number": "910-763-1896",
            "fax_number": "910-763-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S 16TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284018016",
            "telephone_number": "910-763-1896",
            "fax_number": "910-763-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PHARMACY OF WILMINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "VP/MANAGER/SECRETARY",
        "authorized_official_telephone_number": "305-808-9838"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "5247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700605",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC PROVIDER #",
            "identifier": "0405K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655753",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Center Pharmacy of Wilmington, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.