NPIMap

Organization Active NPI

Rocky Mount Medical Park Pharmacy, Inc

  • Community/Retail Pharmacy
  • Rocky Mount, NC
National Provider Identifier
1578830105
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5339 Issued in NC
Legal business name
ROCKY MOUNT MEDICAL PARK PHARMACY, INC
Practice address
901 N Winstead Ave
Suite 100
Rocky Mount, NC 27804-8467
Phone
(252) 443-7979
Fax
(252) 443-7419
NPI assigned
Nov 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Randy Gordon Crawford, RPHNPI 1154611135
Title
President
Phone
(252) 443-7979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5339 NC Primary

Addresses

Primary practice location

901 N Winstead Ave
Suite 100
Rocky Mount, NC 27804-8467

Mailing address

901 N Winstead Ave
Suite 100
Rocky Mount, NC 27804-8467
Phone (252) 443-7979

Other identifiers 2

IdentifierTypeStateIssuer
00335398MedicaidNC
3428035OtherNCNCPDP

Other names 1

  • ROCKY MOUNT MEDICAL PARK PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rocky Mount Medical Park Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

901 N Winstead Ave
Ste 100
Rocky Mount, NC 27804
Phone (252) 443-7979

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1578830105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "address_2": "SUITE 100",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-443-7979",
            "fax_number": "252-443-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "address_2": "SUITE 100",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-443-7979",
            "fax_number": "252-443-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNT MEDICAL PARK PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-443-7979",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "5339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00335398",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3428035",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROCKY MOUNT MEDICAL PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.