Active NPI
Diane Juda, RPH
- Pharmacist
- Southport, NC
National Provider Identifier
1669871422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13068
- Practice address
- 1513 N Howe St
Suite 8
Southport, NC 28461-2769 - Phone
- (910) 454-9090
- NPI assigned
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13068 | NC | Primary |
Addresses
Primary practice location
1513 N Howe St
Suite 8
Southport, NC 28461-2769
Mailing address
2720 Shady Pine Cir
Southport, NC 28461-8239
Phone (410) 340-7260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13068 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1669871422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2720 SHADY PINE CIR",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284618239",
"telephone_number": "410-340-7260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1513 N HOWE ST",
"address_2": "SUITE 8",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284612769",
"telephone_number": "910-454-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDA",
"first_name": "DIANE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "13068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.