Active NPI
Health Park Pharmacy LLC
- Pharmacy
- Raleigh, NC
National Provider Identifier
1679638167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 11200
- Legal business name
- HEALTH PARK PHARMACY LLC
- Practice address
- 8300 Health Park
Suite 227
Raleigh, NC 27615-4731 - Phone
- (919) 847-7645
- Fax
- (919) 847-7641
- NPI assigned
- Dec 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Larry Steven Adkins II
- Title
- Owner/Manager
- Phone
- (919) 847-7645
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 11200 | NC | Primary |
| Community/Retail Pharmacy | 3336C0003X | 9307 | NC | |
| Community/Retail Pharmacy | 3336C0003X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
8300 Health Park
Suite 227
Raleigh, NC 27615-4731
Mailing address
8300 Health Park
Suite 227
Raleigh, NC 27615-4731
Phone (919) 847-7645
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0920708 | Medicaid | NC | |
| 7704623 | Medicaid | NC | |
| 11200 | Other | NC | PHARMACY PERMIT |
| 3407459 | Other | NCPDP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090922000156 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 3375699044 | Practice locations: Raleigh, NC |
| O20100930017007 | NC | DME Supplier - Pharmacy | 3375699044 | Practice locations: Raleigh, NC |
National Provider Directory
National Provider Directory- Tax ID family
- Health Park Pharmacy LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Raleigh, NC
- NPI 1750923678
-
- Community/Retail Pharmacy
- Raleigh, NC
- NPI 1790917375
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1679638167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 HEALTH PARK",
"address_2": "SUITE 227",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276154731",
"telephone_number": "919-847-7645",
"fax_number": "919-857-7641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 HEALTH PARK",
"address_2": "SUITE 227",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276154731",
"telephone_number": "919-847-7645",
"fax_number": "919-847-7641"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTH PARK PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-26",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "ADKINS",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "STEVEN",
"authorized_official_title_or_position": "OWNER/MANAGER",
"authorized_official_telephone_number": "919-847-7645",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "II"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NC",
"license": "11200",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NC",
"license": "9307",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0920708",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7704623",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY PERMIT",
"identifier": "11200",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3407459",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
- Health & Home Services, Inc.
- Health Alert Screening and Diagnostics Imaging Laboratories LLC
- Health Alliance Enterprises
- Health Connect Homecare Solutions LLC
- Health First Community
- Health Park Pharmacy LLC
- Health Park Pharmacy, LLC
- Health Plexus, LLC
- Health Target Nursing Services, PA
- Healthbloom Primary Care & Aesthetics PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.