NPIMap

Organization Active NPI

Oberry Center

Doing business as Oberry Center Pharmacy

  • Long Term Care Pharmacy
  • Goldsboro, NC
National Provider Identifier
1629134994
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
02815 Issued in NC
Legal business name
OBERRY CENTER
Doing business as
Oberry Center Pharmacy
Practice address
400 Old Smithfield Rd
Goldsboro, NC 27530-8464
Phone
(919) 581-4686
Fax
(919) 581-4689
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Carla Dawson, RPH
Title
Pharm and MGR
Phone
(919) 581-4686

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 02815 NC Primary

Addresses

Primary practice location

400 Old Smithfield Rd
Goldsboro, NC 27530-8464

Mailing address

2021 Mail Service Ctr
DHHS Controllers Office
Raleigh, NC 27699-2000
Phone (919) 581-4686

Other identifiers 2

IdentifierTypeStateIssuer
2066138OtherPK
3406028MedicaidNC

Other names 1

  • OBERRY CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
O'Berry Neuro-Medical Treatment Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2021 Mail Service Ctr
Raleigh, NC 27699

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1629134994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 MAIL SERVICE CTR",
            "address_2": "DHHS CONTROLLERS OFFICE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276992000",
            "telephone_number": "919-581-4686",
            "fax_number": "919-581-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD SMITHFIELD RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275308464",
            "telephone_number": "919-581-4686",
            "fax_number": "919-581-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBERRY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "PHARM AND MGR",
        "authorized_official_telephone_number": "919-581-4686",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "02815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2066138",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OBERRY CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OBERRY CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.