NPIMap

Pinehurst Medical Clinic Inc

Organization Active NPI Community/Retail Pharmacy · Pinehurst, NC

NPI 1760784359 · NPPES record last updated Mar 1, 2017

Key facts

NPI
1760784359
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
10639 (NC)
Legal business name
PINEHURST MEDICAL CLINIC INC
Practice address
15 Regional Dr
2ND Floor Lobby
Pinehurst, NC 28374-8850
Phone
(910) 235-3204
Fax
(910) 235-3410
NPI assigned
Dec 2, 2010
Organization subpart
No

Authorized official

Name
Craig Crowe
Title
Pharmacy Manager
Phone
(910) 692-2064

Corporate family (same tax ID) 3

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

Practitioners 13

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

National Provider Directory

Tax ID family
PMC Laboratory Department (4 organizations share this tax ID)

Locations

15 Regional Dr
Fl 2
Pinehurst, NC 28374
Phone (910) 235-3204

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 10639 NC Yes

Addresses

Primary practice location

15 Regional Dr
2ND Floor Lobby
Pinehurst, NC 28374-8850

Mailing address

15 Regional Dr
2ND Floor Lobby
Pinehurst, NC 28374-8850
Phone (910) 235-3204

Other identifiers

IdentifierTypeStateIssuer
0635716MedicaidNC
2127708OtherPK

Other names

  • Pinehurst Medical Clinic Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 1, 2017.

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1760784359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "address_2": "2ND FLOOR LOBBY",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-235-3204",
            "fax_number": "910-235-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "address_2": "2ND FLOOR LOBBY",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-235-3204",
            "fax_number": "910-235-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "CROWE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "910-692-2064"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0635716",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2127708",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinehurst Medical Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinehurst, NC

All providers in Pinehurst, NC · Community/Retail Pharmacy in North Carolina

Sources for this page

Verify at the official NPI Registry.