Active NPI
Dunaways Inc
- Long Term Care Pharmacy
- Cramerton, NC
National Provider Identifier
1508998840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- DUNAWAYS INC
- Practice address
- 102 Hidden Pastures Dr Ste 106
Cramerton, NC 28032-1697 - Phone
- (704) 865-9480
- Fax
- (704) 865-5480
- NPI assigned
- Mar 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jennifer Weathers Ethridge, PHARM.D.
- Title
- President
- Phone
- (704) 865-9480
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
102 Hidden Pastures Dr Ste 106
Cramerton, NC 28032-1697
Mailing address
102 Hidden Pastures Dr Ste 106
Cramerton, NC 28032-1697
Phone (704) 865-9480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0366336 | Medicaid | NC |
Other names 1
- Edgeway Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150224001980 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 3173849833 | Practice locations: Cramerton, NC |
National Provider Directory
National Provider Directory- Tax ID family
- Dunaways Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Gastonia, NC
- NPI 1194384792
Locations
102 Hidden Pastures Dr
Ste 102
Cramerton, NC 28032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1552608000000",
"number": "1508998840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 HIDDEN PASTURES DR STE 106",
"city": "CRAMERTON",
"state": "NC",
"postal_code": "280321697",
"telephone_number": "704-865-9480",
"fax_number": "704-865-5480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 HIDDEN PASTURES DR STE 106",
"city": "CRAMERTON",
"state": "NC",
"postal_code": "280321697",
"telephone_number": "704-865-9480",
"fax_number": "704-865-5480"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DUNAWAYS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-12",
"last_updated": "2019-03-15",
"status": "A",
"authorized_official_last_name": "ETHRIDGE",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "WEATHERS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "704-865-9480",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM.D."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0366336",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Edgeway Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Edgeway Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cramerton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.