Pharmacy Plus of New Bern, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4747 Issued in NC

Legal business name

PHARMACY PLUS OF NEW BERN, INC

Practice address

1204 S Glenburnie Rd
New Bern, NC 28562-2609

Phone

(252) 636-3322

Fax

(252) 636-5070

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. C Stroud Tilley III, RPH

Title

Vice President

Phone

(252) 636-3322

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1548288996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 WHITE HORSE DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347829",
            "telephone_number": "252-752-2363",
            "fax_number": "252-752-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 S GLENBURNIE RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622609",
            "telephone_number": "252-636-3322",
            "fax_number": "252-636-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY PLUS OF NEW BERN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "STROUD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "252-636-3322",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "4747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3424049",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7701205",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0255463",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kizzy Hargett Petersen, FNP, PMHNP
• John A Peterson, PA C
• Vivian Marie Peterson, MD
• Alesia Petini
• Lorine Petty Staten
• Tiffany Dee Phasukkan, BCBA
• Shelly Phillips-Dean
• John Michael Phillips, PHARMD
• Keely Phillips
• Michael Jay Phillips, MD

• Community/Retail Pharmacy in New Bern, NC
• Providers in New Bern, 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 Apr 16, 2010; 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.