NPIMap

Organization Active NPI

Professional Specialty Pharmacy, LLC

Doing business as Professional Specialty Pharmacy

  • Compounding Pharmacy
  • Oxford, NC
National Provider Identifier
1811247257
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
11338 Issued in NC
Legal business name
PROFESSIONAL SPECIALTY PHARMACY, LLC
Doing business as
Professional Specialty Pharmacy
Practice address
142 Roxboro Rd
Oxford, NC 27565-2642
Phone
(919) 603-3824
Fax
(919) 603-3847
NPI assigned
Sep 13, 2012
Last updated
Sep 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Susan Bowman
Title
Member/Manager
Phone
(919) 603-3824

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X NU
Compounding Pharmacy 3336C0004X 11338 NC Primary

Addresses

Primary practice location

142 Roxboro Rd
Oxford, NC 27565-2642

Mailing address

142 Roxboro Rd
Oxford, NC 27565-2642
Phone (919) 603-3824

Other identifiers 1

IdentifierTypeStateIssuer
3460401OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Professional Specialty Pharmacy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1811247257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 ROXBORO RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275652642",
            "telephone_number": "919-603-3824",
            "fax_number": "919-603-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 ROXBORO RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275652642",
            "telephone_number": "919-603-3824",
            "fax_number": "919-603-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SPECIALTY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "919-603-3824"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NC",
            "license": "11338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3460401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.