Pungo River Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

04520 Issued in NC

Legal business name

PUNGO RIVER PHARMACY INC

Practice address

892 US Highway 264 Byp
Belhaven, NC 27810-9771

Phone

(252) 943-2585

Fax

(252) 943-3076

NPI assigned

Mar 9, 2007

Last updated

Sep 26, 2011By 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

Scott Ellis, RPHNPI 1811149701

Title

President

Phone

(252) 943-2585

Specialties & licenses 2

Addresses

Other identifiers 2

Practitioners 2

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.

• Scott John Ellis, RPH,CFO

  • Pharmacist
  • Belhaven, NC
  • NPI 1811149701
  NPD (past) Authorized official
• Meagan Lauren Phelps, C.PED

  • Orthotic Fitter
  • Belhaven, NC
  • NPI 1073845152
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1588795488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 US HIGHWAY 264 BYP",
            "city": "BELHAVEN",
            "state": "NC",
            "postal_code": "278109771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 US HIGHWAY 264 BYP",
            "city": "BELHAVEN",
            "state": "NC",
            "postal_code": "278109771",
            "telephone_number": "252-943-2585",
            "fax_number": "252-943-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUNGO RIVER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-943-2585",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "04520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3403780",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075242",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pungo District Hospital Corporation (Vidant Pungo Hospital)
• Pungo District Hospital Corporation (Vidant Pungo Hospital)
• Pungo District Hospital Corporation
• Pungo Family Medicine PA
• Pungo River Pharmacy Inc
• R and R in Belhaven LLC (Belhaven Medical Supply)
• R and R in Belhaven, LLC (Belhaven Medical Supply)
• Cameron Blake Smith, FNP-C
• Paige Marie Stephens, DNP, FNP
• Rachel Marie Swartwood, PHARMD

• Community/Retail Pharmacy in Belhaven, NC
• Providers in Belhaven, 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 Sep 26, 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.