Everett Lee Lewis Jr., R.PH. – Pharmacist

Key facts

NPI: 1487878393
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 6586 (NC)
Practice address: 111A N Hoffman St
Dallas, NC 28034-1597
Phone: (704) 922-3001
Fax: (704) 922-0060
NPI assigned: Apr 12, 2007
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
6586	NC	MD	Speech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	6586	NC	Yes

Addresses

Primary practice location

111A N Hoffman St
Dallas, NC 28034-1597

Mailing address

111A N Hoffman St
Dallas, NC 28034-1597
Phone (704) 922-3001

Other identifiers

Identifier	Type	State	Issuer
6586	Other	NC	PHARMACIST LICENSE NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487878393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111A N HOFFMAN ST",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341597",
            "telephone_number": "704-922-3001",
            "fax_number": "704-922-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111A N HOFFMAN ST",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341597",
            "telephone_number": "704-922-3001",
            "fax_number": "704-922-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "EVERETT",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "6586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "6586",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, NC

All providers in Dallas, NC · Pharmacist in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.