Organization Active NPI

Hillcrest Convalescent Center Inc

  • Long Term Care Pharmacy
  • Durham, NC
National Provider Identifier
1710048582
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
02265 Issued in NC
Legal business name
HILLCREST CONVALESCENT CENTER INC
Practice address
1417 W Pettigrew St
Durham, NC 27705-4820
Phone
(919) 286-7705
Fax
(919) 286-2065
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Authorized official

Name
Harris Hollingsworth, RPH
Title
Dir of Phcy
Phone
(919) 286-7705

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 02265 NC Primary

Addresses

Primary practice location

1417 W Pettigrew St
Durham, NC 27705-4820

Mailing address

1417 W Pettigrew St
Durham, NC 27705-4820
Phone (919) 286-7705

Other identifiers 2

IdentifierTypeStateIssuer
325282MedicaidNC
2065765OtherPK

Other names 1

  • HILLCREST CONVALESCENT CENTER INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hillcrest Convalescent Center Inc3 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.

Locations

1417 W Pettigrew St
Durham, NC 27705
Phone (919) 286-7705

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1710048582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 W PETTIGREW ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054820",
            "telephone_number": "919-286-7705",
            "fax_number": "919-286-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 W PETTIGREW ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054820",
            "telephone_number": "919-286-7705",
            "fax_number": "919-286-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST CONVALESCENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "HOLLINGSWORTH",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "DIR OF PHCY",
        "authorized_official_telephone_number": "919-286-7705",
        "authorized_official_credential": "RPH"
    },
    "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": "02265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325282",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065765",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HILLCREST CONVALESCENT CENTER INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.