Community Pharmacy of Vale LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12064 Issued in NC

Legal business name

COMMUNITY PHARMACY OF VALE LLC

Doing business as

The Drug Store Vale

Practice address

9576 NC Hwy 10 W
Vale, NC 28168-9511

Phone

(704) 462-0226

Fax

(704) 462-0229

NPI assigned

Oct 9, 2015

Last updated

Oct 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Phillipe HullNPI 1669553814

Title

President

Phone

(704) 462-0226

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Drug Store Vale Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Community Pharmacy of Vale LLC

  dba The Drug Store Vale

  • Community/Retail Pharmacy
  • Vale, NC
  • NPI 1912170507

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Phillip Hull, PHARMD

  • Pharmacist
  • Vale, NC
  • NPI 1669553814
  Authorized official Same address or phone

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1760853279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9576 NC HWY 10 W",
            "city": "VALE",
            "state": "NC",
            "postal_code": "281689511",
            "telephone_number": "704-462-0226",
            "fax_number": "704-462-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9576 NC HWY 10 W",
            "city": "VALE",
            "state": "NC",
            "postal_code": "281689511",
            "telephone_number": "704-462-0226",
            "fax_number": "704-462-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY OF VALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "PHILLIPE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-462-0226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0186299",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Drug Store Vale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Granville Williams Angell, EDS, LPC, NCC
• Trina L. Beighley, RN
• Wanda Renee Brackett
• Shannon Elizabeth Carpenter, LCSWA
• Community Pharmacy of Vale LLC (The Drug Store - Vale)
• Community Pharmacy of Vale LLC (The Drug Store Vale)
• Elle Tallent Dellinger
• Joel Douglas Elam, PA-C
• Elle Dellinger Speech Services, PLLC
• Katherine Evans

• Community/Retail Pharmacy in Vale, NC
• Providers in Vale, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.