Columbia Pharmacy, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

09900 Issued in NC

Legal business name

COLUMBIA PHARMACY, INC

Doing business as

Columbia Pharmacy

Practice address

214 Main Street
Columbia, NC 27925

Phone

(252) 796-2421

Fax

(252) 796-1124

NPI assigned

May 19, 2010

Last updated

Oct 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Dana Outten, RPH

Title

Pharmacist/Manager/Owner

Phone

(252) 796-2421

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Columbia Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Columbia Pharmacy Inc

  dba Columbia Pharmacy

  • Community/Retail Pharmacy
  • Columbia, NC
  • NPI 1982626552

  6507985231

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Columbia Pharmacy Inc

  dba Columbia Pharmacy

  • Community/Retail Pharmacy
  • Columbia, NC
  • NPI 1982626552

  O20130515000410

  Same enrollment

Tax ID family

Columbia Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Columbia Pharmacy Inc

  dba Columbia Pharmacy

  • Long Term Care Pharmacy
  • Columbia, NC
  • NPI 1689591554
  NPD tax ID
• Columbia Pharmacy Inc

  dba Columbia Pharmacy

  • Community/Retail Pharmacy
  • Columbia, NC
  • NPI 1982626552
  NPD tax ID

Locations

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1518286368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 239",
            "city": "COLUMBIA",
            "state": "NC",
            "postal_code": "279250239",
            "telephone_number": "252-796-2421",
            "fax_number": "252-796-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MAIN STREET",
            "city": "COLUMBIA",
            "state": "NC",
            "postal_code": "27925",
            "telephone_number": "252-796-2421",
            "fax_number": "252-796-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "OUTTEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DANA",
        "authorized_official_title_or_position": "PHARMACIST/MANAGER/OWNER",
        "authorized_official_telephone_number": "252-796-2421",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "09900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0895060",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700971",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Columbia, NC
• Providers in Columbia, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.

Verify at the official NPI Registry.