Individual provider Active NPI

Luke Lazarus Marion, RPH

  • Pharmacist
  • Winston Salem, NC
National Provider Identifier
1598197899
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
06805 Issued in NC
Practice address
2221 Cloverdale Ave
Winston Salem, NC 27103-2301
Phone
(336) 724-7491
Fax
(336) 724-9674
NPI assigned
Aug 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 06805 NC Primary

Addresses

Primary practice location

2221 Cloverdale Ave
Winston Salem, NC 27103-2301

Mailing address

2221 Cloverdale Ave
Winston Salem, NC 27103-2301
Phone (336) 724-7491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
06805NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1598197899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 CLOVERDALE AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032301",
            "telephone_number": "336-724-7491",
            "fax_number": "336-724-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 CLOVERDALE AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032301",
            "telephone_number": "336-724-7491",
            "fax_number": "336-724-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARION",
        "first_name": "LUKE",
        "middle_name": "LAZARUS",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "06805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.