NPIMap

Organization Active NPI

Select Care Pharmacy LLC

  • Long Term Care Pharmacy
  • Arden, NC
National Provider Identifier
1689048381
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
12746 Issued in NC
Legal business name
SELECT CARE PHARMACY LLC
Practice address
15 Glenn Bridge Rd Ste a
Arden, NC 28704-8481
Phone
(828) 585-2034
Fax
(855) 782-5622
NPI assigned
Nov 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Darin CunninghamNPI 1396066452
Title
President
Phone
(843) 452-3891

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 12746 NC Primary

Addresses

Primary practice location

15 Glenn Bridge Rd Ste a
Arden, NC 28704-8481

Mailing address

15 Glenn Bridge Rd Ste a
Arden, NC 28704-8481
Phone (828) 585-2034

Other identifiers 2

IdentifierTypeStateIssuer
1689048381MedicaidNC
2155359OtherPK

Other names 1

  • Select Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210414000310 NC Part B Supplier - Mass Immunization (Roster Biller Only) 6305107541 Practice locations: Arden, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

15 Glenn Bridge Rd
Ste A
Arden, NC 28704
Phone (828) 585-2034

Practitioners & affiliated clinicians

Practitioners 1

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": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1689048381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GLENN BRIDGE RD STE A",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287048481",
            "telephone_number": "828-585-2034",
            "fax_number": "855-782-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GLENN BRIDGE RD STE A",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287048481",
            "telephone_number": "828-585-2034",
            "fax_number": "855-782-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT CARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "DARIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-452-3891"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "12746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689048381",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155359",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Select Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.

Verify at the official NPI Registry.