Hazelwood Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

04034 Issued in NC

Legal business name

HAZELWOOD PHARMACY INC

Practice address

429 Hazelwood Ave
Hazelwood, NC 28786-1946

Phone

(828) 456-5481

Fax

(828) 452-2120

NPI assigned

Mar 13, 2007

Last updated

Sep 12, 2007By 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

Geraldine Keenum James

Title

Pharmacist Manager

Phone

(828) 456-5481

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1790817724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "HAZELWOOD",
            "state": "NC",
            "postal_code": "287380247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 HAZELWOOD AVE",
            "city": "HAZELWOOD",
            "state": "NC",
            "postal_code": "287861946",
            "telephone_number": "828-456-5481",
            "fax_number": "828-452-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZELWOOD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "KEENUM JAMES",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "PHARMACIST MANAGER",
        "authorized_official_telephone_number": "828-456-5481"
    },
    "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": "04034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445049",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3407170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3407170",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.