Healthsmart Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10131 Issued in NC

Legal business name

HEALTHSMART PHARMACY LLC

Practice address

108 Leaning Oak Dr
Mooresville, NC 28117

Phone

(704) 658-1184

Fax

(794) 658-1184

NPI assigned

Jul 17, 2008

Organization subpart

No

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

Authorized official

Name

Doug Balog

Title

Manager

Phone

(704) 906-0281

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• HEALTHSMART PHARMACY Doing business as

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1780848804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 LEANING OAK DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-658-1184",
            "fax_number": "794-658-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LEANING OAK DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-658-1184",
            "fax_number": "794-658-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSMART PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "BALOG",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-906-0281"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497682",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3411458",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHSMART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mooresville, NC
• Providers in Mooresville, 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 Dec 2, 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.