Pembroke Drug Center

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

PEMBROKE DRUG CENTER

Doing business as

Healthkeeperz

Practice address

4155 Ferncreek Dr
Fayetteville, NC 28314-2581

Phone

(910) 485-7131

Fax

(910) 485-7132

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Timothy B Brooks

Title

President

Phone

(910) 522-0001

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthkeeperz Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1720173396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1030",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283721030",
            "telephone_number": "910-522-0009",
            "fax_number": "910-521-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 FERNCREEK DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142581",
            "telephone_number": "910-485-7131",
            "fax_number": "910-485-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE DRUG CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-522-0001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704496",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthkeeperz",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pelham Supportive Services
• Pelham Supportive Services
• Maya Pelletier
• Kamari Pemberton
• Sharisse Desheal Pemberton
• Subbarao Venkata Pemmaraju, M.D.
• Michelle Pendergraph
• Satisha Pendergrast
• Linda Pendleton, P.H.D.
• Aimee Penebacker

• Oxygen Equipment & Supplies (DME) in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Oxygen Equipment & Supplies (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.