Active NPI
Medi-Service of Charlotte Inc
- Community/Retail Pharmacy
- Monroe, NC
National Provider Identifier
1821195751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 11378
- Legal business name
- MEDI-SERVICE OF CHARLOTTE INC
- Practice address
- 610 E Franklin St
Monroe, NC 28112-5702 - Phone
- (704) 289-1523
- Fax
- (855) 841-5354
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robin Fleischman
- Title
- Owner
- Phone
- (704) 516-2121
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 11378 | NC | Primary |
Addresses
Primary practice location
610 E Franklin St
Monroe, NC 28112-5702
Mailing address
610 E Franklin St
Monroe, NC 28112-5702
Phone (704) 289-1523
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2137361 | Other | PK | |
| 000068587 | Medicaid | SC | |
| 0905257 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210304002676 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 5294853958 | Practice locations: Monroe, NC |
National Provider Directory
National Provider DirectoryLocations
610 E Franklin St
Monroe, NC 28112
Phone (704) 289-1523
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Monroe, NC
- NPI 1992583108
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1508803200000",
"number": "1821195751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E FRANKLIN ST",
"city": "MONROE",
"state": "NC",
"postal_code": "281125702",
"telephone_number": "704-289-1523",
"fax_number": "704-289-4758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 E FRANKLIN ST",
"city": "MONROE",
"state": "NC",
"postal_code": "281125702",
"telephone_number": "704-289-1523",
"fax_number": "855-841-5354"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDI-SERVICE OF CHARLOTTE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2017-10-24",
"status": "A",
"authorized_official_last_name": "FLEISCHMAN",
"authorized_official_first_name": "ROBIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "704-516-2121"
},
"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": "11378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2137361",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000068587",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0905257",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.