NPIMap

Organization Active NPI

Triad Adult and Pediatric Med- Greensboro Pharmacy

  • Community/Retail Pharmacy
  • Greensboro, NC
National Provider Identifier
1801205018
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
106710 Issued in NC
Legal business name
TRIAD ADULT AND PEDIATRIC MED- GREENSBORO PHARMACY
Practice address
1002 S Eugene St
Greensboro, NC 27406-1308
Phone
(336) 355-9909
Fax
(336) 676-6170
NPI assigned
Aug 13, 2014
Organization subpart
Yes
Parent organization
TRIAD ADULT AND PEDIATRIC MEDICINE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Ms. Amy Hallisey, RPH
Title
Pharmacy Director
Phone
(336) 355-9912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 106710 NC Primary

Addresses

Primary practice location

1002 S Eugene St
Greensboro, NC 27406-1308

Mailing address

1002 S Eugene St
Greensboro, NC 27406-1308
Phone (336) 355-9909

Other identifiers 1

IdentifierTypeStateIssuer
344045BMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Triad Adult and Pediatric Medicine Inc16 organizations share this tax ID, including this one
Part of
Triad Adult and Pediatric Medicine Inc

Other organizations with this tax ID 15

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

View all 15

Locations

1002 S Eugene St
Greensboro, NC 27406
Phone (336) 271-5999

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1801205018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 S EUGENE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274061308",
            "telephone_number": "336-355-9909",
            "fax_number": "336-676-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 S EUGENE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274061308",
            "telephone_number": "336-355-9909",
            "fax_number": "336-676-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD ADULT AND PEDIATRIC MED- GREENSBORO PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIAD ADULT AND PEDIATRIC MEDICINE, INC.",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "HALLISEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "336-355-9912",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "106710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344045B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.