NPIMap

Organization Active NPI

Innovative Compounding

  • Community/Retail Pharmacy
  • Whitsett, NC
National Provider Identifier
1629370481
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10636 Issued in NC
Legal business name
INNOVATIVE COMPOUNDING
Practice address
941 Center Crest Dr
Suite D
Whitsett, NC 27377
Phone
(336) 447-4803
Fax
(336) 447-4805
NPI assigned
Nov 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Sharon Wilson
Title
Pharmacy Manager/Pharmacist
Phone
(336) 447-4803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 10636 NC Primary

Addresses

Primary practice location

941 Center Crest Dr
Suite D
Whitsett, NC 27377

Mailing address

941 Center Crest Dr
Suite D
Whitsett, NC 27377
Phone (336) 447-4803

National Provider Directory

National Provider Directory
Tax ID family
Innovative Compounding2 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.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1629370481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 CENTER CREST DR",
            "address_2": "SUITE D",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "27377",
            "telephone_number": "336-447-4803",
            "fax_number": "336-447-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 CENTER CREST DR",
            "address_2": "SUITE D",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "27377",
            "telephone_number": "336-447-4803",
            "fax_number": "336-447-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE COMPOUNDING",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "PHARMACY MANAGER/PHARMACIST",
        "authorized_official_telephone_number": "336-447-4803"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitsett, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.