Wayne Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12912 Issued in NC

Legal business name

WAYNE PHARMACY, INC.

Practice address

2302 Wayne Memorial Dr
Goldsboro, NC 27534-1726

Phone

(919) 735-6936

Fax

(919) 735-1109

NPI assigned

May 27, 2016

Last updated

May 27, 2016By 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

Kenneth L Wiggins Jr.

Title

Corporation President

Phone

(919) 735-6936

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Johnston Medical Supply3 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.

• Wayne Pharmacy Inc

  • Community/Retail Pharmacy
  • Goldsboro, NC
  • NPI 1659824274
  NPD tax ID
• Wayne Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Goldsboro, NC
  • NPI 1790853810
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Ellen Gordon

  • Orthotic Fitter
  • Smithfield, NC
  • NPI 1942405873
  NPD (past)

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1528416898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275341726",
            "telephone_number": "919-735-6936",
            "fax_number": "919-735-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275341726",
            "telephone_number": "919-735-6936",
            "fax_number": "919-735-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CORPORATION PRESIDENT",
        "authorized_official_telephone_number": "919-735-6936",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "12912",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0965046",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wayne Memorial Hospital Inc (UNC Health Wayne)
• Wayne MRI, LLC
• Wayne Opportunity Center
• Wayne Pharmacy Inc
• Wayne Pharmacy, Inc
• Wayne Pharmacy, Inc.
• Wayne Preparatory Academy
• Wayne Psychiatric Associates, PA
• Wayne Radiologists P a
• Wayne Urological Associates PA

• Community/Retail Pharmacy in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.