NPIMap

Organization Active NPI

Village Pharmacy of Wake Forest LLC

  • Community/Retail Pharmacy
  • Wake Forest, NC
National Provider Identifier
1649402017
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10359 Issued in NC
Legal business name
VILLAGE PHARMACY OF WAKE FOREST LLC
Practice address
900 S Franklin St
Suite 102
Wake Forest, NC 27587-2797
Phone
(919) 556-2757
Fax
(919) 556-2757
NPI assigned
Aug 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Arthur H Minton, RPHNPI 1578893269
Title
Owner
Phone
(919) 556-2757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 10359 NC Primary
Compounding Pharmacy 3336C0004X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

900 S Franklin St
Suite 102
Wake Forest, NC 27587-2797

Mailing address

900 S Franklin St
Suite 102
Wake Forest, NC 27587-2797
Phone (919) 556-2757

Other identifiers 1

IdentifierTypeStateIssuer
0920310MedicaidNC

National Provider Directory

National Provider Directory

Locations

900 S Franklin St
Ste 102
Wake Forest, NC 27587
Phone (919) 556-2757

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": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1649402017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S FRANKLIN ST",
            "address_2": "SUITE 102",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872797",
            "telephone_number": "919-556-2757",
            "fax_number": "919-556-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S FRANKLIN ST",
            "address_2": "SUITE 102",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872797",
            "telephone_number": "919-556-2757",
            "fax_number": "919-556-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PHARMACY OF WAKE FOREST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "MINTON",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-556-2757",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10359",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0920310",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.