Active NPI
Hillcrest Convalescent Center Inc
- Long Term Care Pharmacy
- Durham, NC
National Provider Identifier
1710048582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- 02265
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 325282 | Medicaid | NC | |
| 2065765 | Other | PK |
Other names 1
- HILLCREST CONVALESCENT CENTER INC
National Provider Directory
National Provider Directory- Tax ID family
- Hillcrest Convalescent Center Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Durham, NC
- NPI 1336142470
-
- Rehabilitation Clinic/Center
- Durham, NC
- NPI 1659901130
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.
-
- Physical Therapist
- Durham, NC
- NPI 1225382039
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.