Organization Active NPI

GPN Express Enterprise LLC

  • Community/Retail Pharmacy
  • Hampstead, NC
National Provider Identifier
1609024595
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GPN EXPRESS ENTERPRISE LLC
Practice address
14057 US Highway 17 N
Suite 100
Hampstead, NC 28443-3770
Phone
(910) 319-6050
Fax
(910) 319-6045
NPI assigned
Sep 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Authorized official

Name
Nhat Quy Trinh
Title
Member
Phone
(910) 319-6050

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 10151 NC
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

14057 US Highway 17 N
Suite 100
Hampstead, NC 28443-3770

Mailing address

14057 US Highway 17 N
Suite 100
Hampstead, NC 28443-3770
Phone (910) 319-6050

Other identifiers 2

IdentifierTypeStateIssuer
00432780MedicaidNC
15085OtherNCPHARMACY PERMIT

Other names 1

  • Village Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20071117000147 NC Part B Supplier - Mass Immunization (Roster Biller Only) 0749378172 3 other NPIs on this enrollment
Practice locations: Hampstead, NC
O20230816004204 NC Part B Supplier - Pharmacy 4688036064 Practice locations: Hampstead, NC
O20231027002675 NC Part B Supplier - Mass Immunization (Roster Biller Only) 4688036064 Practice locations: Hampstead, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

14057 US Highway 17
Ste 100
Hampstead, NC 28443
Phone (910) 319-6050

7910 US Hwy 117 S
Unit 110
Rocky Point, NC 28457
Phone (910) 210-2030

8207 Market St
Ste A
Wilmington, NC 28411
Phone (910) 686-1110

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": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1609024595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14057 US HIGHWAY 17 N",
            "address_2": "SUITE 100",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433770",
            "telephone_number": "910-319-6050",
            "fax_number": "910-319-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14057 US HIGHWAY 17 N",
            "address_2": "SUITE 100",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433770",
            "telephone_number": "910-319-6050",
            "fax_number": "910-319-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GPN EXPRESS ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "TRINH",
        "authorized_official_first_name": "NHAT QUY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "910-319-6050"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10151",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00432780",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "15085",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampstead, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.