Spencers Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201000758 Issued in VA

Legal business name

SPENCERS DRUG STORE INC

Doing business as

Spencers Drug Store Inc

Practice address

100 N Main St
Blackstone, VA 23824-1424

Phone

(434) 292-3132

Fax

(434) 292-6467

NPI assigned

Dec 11, 2006

Last updated

Nov 29, 2016By 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

Keri YanceyNPI 1306432943

Title

Owner

Phone

(434) 292-3132

Specialties & licenses 3

Addresses

Other names 1

• Spencers Drug Store Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Tax ID family

Spencers Drug Store Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Spencer's Drug Store, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Blackstone, VA
  • NPI 1235125360
  NPD tax ID

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.

• Keri Hoye Yancey, PHARM D

  • Pharmacist
  • Blackstone, VA
  • NPI 1306432943
  NPD Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1780744490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238241424",
            "telephone_number": "434-292-3132",
            "fax_number": "434-292-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238241424",
            "telephone_number": "434-292-3132",
            "fax_number": "434-292-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCERS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "YANCEY",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-292-3132"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201000758",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spencers Drug Store Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michaela Nicole Cruz San Juan, MD
• Rauan Satbekov, M.D.
• Specialty Healthcare
• Steven N. Spence, M.D.
• Spencer's Drug Store, Inc.
• Kristina Diane Staples, DDS.
• Starke Behavioral Health Association Inc
• Starke Behavioral Health Services LLC
• Tisha Stewart, CERTIFIED PHLEBOTOMY
• Dennis D Swan, M.D.

• Community/Retail Pharmacy in Blackstone, VA
• Providers in Blackstone, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.