Organization Active NPI

Family Pharmacy of Louisburg, L.L.C.

  • Community/Retail Pharmacy
  • Louisburg, NC
National Provider Identifier
1477860930
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9590 Issued in NC
Legal business name
FAMILY PHARMACY OF LOUISBURG, L.L.C.
Practice address
339 S Bickett Blvd
Louisburg, NC 27549-2701
Phone
(919) 340-1100
Fax
(919) 340-1101
NPI assigned
Sep 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Mrs. Patricia Johnson Person, RPH
Title
Pharmacist Manager/Owner
Phone
(919) 340-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 9590 NC Primary

Addresses

Primary practice location

339 S Bickett Blvd
Louisburg, NC 27549-2701

Mailing address

339 S Bickett Blvd
Louisburg, NC 27549-2701
Phone (919) 340-1100

Other identifiers 1

IdentifierTypeStateIssuer
0355321MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110228000030 NC DME Supplier - Pharmacy 8426239286 Practice locations: Louisburg, NC
O20120208000125 NC Part B Supplier - Mass Immunization (Roster Biller Only) 8426239286 Practice locations: Louisburg, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Family Pharmacy of Louisburg339 S. Bickett Blvd, Louisburg, NC 27549-2701(919) 340-1100 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Dec 14, 2010

National Provider Directory

National Provider Directory

Locations

339 S Bickett Blvd
Louisburg, NC 27549
Phone (919) 340-1100

Practitioners & affiliated clinicians

Practitioners 1

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": "1283731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1477860930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 S BICKETT BLVD",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492701",
            "telephone_number": "919-340-1100",
            "fax_number": "919-340-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 S BICKETT BLVD",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492701",
            "telephone_number": "919-340-1100",
            "fax_number": "919-340-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY OF LOUISBURG, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-06",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "PERSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "PHARMACIST MANAGER/OWNER",
        "authorized_official_telephone_number": "919-340-1100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "9590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0355321",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.