NPIMap

Organization Active NPI

North Carolina Cntrl Univ

Doing business as Student Health Services Pharmacy

  • Community/Retail Pharmacy
  • Durham, NC
National Provider Identifier
1487977799
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5196 Issued in NC
Legal business name
NORTH CAROLINA CNTRL UNIV
Doing business as
Student Health Services Pharmacy
Practice address
200 Cafeteria Drive
Durham, NC 27707
Phone
(919) 530-5465
Fax
(919) 530-7968
NPI assigned
Mar 2, 2010
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Kimberly Dobson
Title
Business Manager
Phone
(919) 530-7336

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5196 NC Primary

Addresses

Primary practice location

200 Cafeteria Drive
Durham, NC 27707

Mailing address

PO Box 19491
Durham, NC 27707-0020
Phone (919) 530-5465

Other identifiers 2

IdentifierTypeStateIssuer
2070969OtherPK
0326804MedicaidNC

Other names 1

  • Student Health Services Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Carolina Cntrl Univ5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1487977799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19491",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277070020",
            "telephone_number": "919-530-5465",
            "fax_number": "919-530-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CAFETERIA DRIVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27707",
            "telephone_number": "919-530-5465",
            "fax_number": "919-530-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA CNTRL UNIV",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "DOBSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "919-530-7336"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "5196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2070969",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0326804",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Health Services Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.