Innovative Meds RX

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11190 Issued in NC

Legal business name

INNOVATIVE MEDS RX

Practice address

364 N South St
Mount Airy, NC 27030-3532

Phone

(336) 789-5050

Fax

(336) 786-7169

NPI assigned

Dec 9, 2011

Organization subpart

No

Name

Richard Kos

Title

President

Phone

(919) 475-8706

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neil Lucas Edlen, PHARMD.

  • Pharmacist
  • Mount Airy, NC
  • NPI 1598066466
  NPD
• Candace Hayley Wood, PHARMD

  • Pharmacist
  • Mt. Airy, NC
  • NPI 1457648131
  NPD

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Tax ID family

Gates Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Innovative Meds RX

  • Long Term Care Pharmacy
  • Mount Airy, NC
  • NPI 1831937101
  NPD tax ID

Locations

• Gates Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 6, 2021.

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1700154366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 N SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303532",
            "telephone_number": "336-789-5050",
            "fax_number": "336-786-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 N SOUTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303532",
            "telephone_number": "336-789-5050",
            "fax_number": "336-786-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MEDS RX",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "KOS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-475-8706"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3459953",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gates Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gates Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Jade Hughes Westmoreland, MS, CCC-SLP
• Kelly Inman Hull, PHARMD
• Jeffrey Lynn Hunter, DPM
• Stefanie Jean Hutson, MSN, RN
• Carl Anthony Hutton, PA
• Innovative Meds RX
• Instride Foot & Ankle Specialists, PLLC
• David Dewitt Jackson, MD
• Joseph A Jackson, MD
• Kellie Suzanne Jackson, RN

• All providers in Mount Airy, NC
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.