NPIMap

Organization Active NPI

Lake Escape Inc

  • Community/Retail Pharmacy
  • Burlington, NC
National Provider Identifier
1487805701
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5919 Issued in NC
Legal business name
LAKE ESCAPE INC
Doing business as
Medicap Pharmacy
Practice address
378 W Harden St
Burlington, NC 27215-7516
Phone
(336) 222-9811
NPI assigned
Oct 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Paul D Smith, RPH
Title
Owner
Phone
(336) 222-9811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5919 NC Primary

Addresses

Primary practice location

378 W Harden St
Burlington, NC 27215-7516

Mailing address

378 W Harden St
Burlington, NC 27215-7516
Phone (336) 222-9811

Other names 1

  • Medicap Pharmacy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1487805701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 W HARDEN ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272157516",
            "telephone_number": "336-222-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 W HARDEN ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272157516",
            "telephone_number": "336-222-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ESCAPE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-222-9811",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "5919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicap Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.