Southern Pines Prescription Shoppe

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

07585 Issued in NC

Legal business name

SOUTHERN PINES PRESCRIPTION SHOPPE

Practice address

1902 N Sandhills Blvd Ste B
Aberdeen, NC 28315-2347

Phone

(910) 692-7467

NPI assigned

Nov 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jon Patrick McClain

Title

Owner

Phone

(910) 692-7467

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Prescription Shoppe3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Prescription Shoppe

  • Community/Retail Pharmacy
  • Pinehurst, NC
  • NPI 1891817193
  NPD tax ID
• Southern Pines Prescription Shop Inc

  • Community/Retail Pharmacy
  • Robbins, NC
  • NPI 1164560009
  NPD tax ID

Locations

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659448371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 N SANDHILLS BLVD STE B",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283152347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 N SANDHILLS BLVD STE B",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283152347",
            "telephone_number": "910-692-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PINES PRESCRIPTION SHOPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLAIN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-692-7467",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "07585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703459",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serenity Mental and Medical Care PLLC (Philip R Couch Sole Mbr)
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• Stefanie Alice Ledford Sittmann, WHNP-BC
• Crystal Freeman Smith, FNP
• Maggie Elaine Smith
• Specialized Services & Personnel Inc
• Specialized Services & Personnel, Inc.
• Donna Stephens Johnson, LMBT, MMP
• Michael Stiranka, PA
• Kennedy Lynn Stray, PHARMD

• Community/Retail Pharmacy in Aberdeen, NC
• Providers in Aberdeen, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.