Service Drug Store of Pinetops Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

04750 Issued in NC

Legal business name

SERVICE DRUG STORE OF PINETOPS INC

Doing business as

Service Drug Store

Practice address

102 West Hamlet Street
Pinetops, NC 27864

Phone

(252) 827-5532

Fax

(252) 827-2741

NPI assigned

Nov 14, 2006

Last updated

Jan 5, 2011By 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

Johnny Hogg

Title

Owner

Phone

(252) 527-5532

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SERVICE DRUG STORE Doing business as

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1811069321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX O",
            "city": "PINETOPS",
            "state": "NC",
            "postal_code": "278640350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WEST HAMLET STREET",
            "city": "PINETOPS",
            "state": "NC",
            "postal_code": "27864",
            "telephone_number": "252-827-5532",
            "fax_number": "252-827-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICE DRUG STORE OF PINETOPS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "HOGG",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-527-5532"
    },
    "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": "04750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0335042",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3409720",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERVICE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyseem's Unity Group Home, LLC
• Pinetops Pharmacy, Inc.
• Lindsey Poythress, PA-C
• S and J Drug Company, LLC (Stallings Drug)
• Howard Brady Saunders, DDS
• Aquilla Monique Silver
• Jessi Stallings, PHARMD
• The Village Group LLC
• Tawanda Tenika Tillery
• Kayla Whitlock

• Community/Retail Pharmacy in Pinetops, NC
• Providers in Pinetops, 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 Jan 5, 2011; 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.