Brevard Drug Company LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10409 Issued in NC

Legal business name

BREVARD DRUG COMPANY LLC

Doing business as

Brevard Drug Company

Practice address

518 S Broad St
Brevard, NC 28712-4438

Phone

(828) 883-9757

Fax

(828) 883-2156

NPI assigned

Jun 12, 2008

Last updated

Aug 1, 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

Jeffrey Jackson

Title

President

Phone

(828) 883-9757

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BREVARD DRUG COMPANY Doing business as

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312156800000",
    "number": "1821258807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 S BROAD ST",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287124438",
            "telephone_number": "828-883-9757",
            "fax_number": "828-883-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 S BROAD ST",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287124438",
            "telephone_number": "828-883-9757",
            "fax_number": "828-883-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD DRUG COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2011-08-01",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-883-9757"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3411484",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0885294",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BREVARD DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David T Braun, M.D.
• Jacquelyn Lee Bray, D.MIN, LPC
• Brevard Chiropractic Center PA
• Brevard College (Brevard College Student Health Center)
• Brevard College (Brevard College Athletics)
• Brevard Hearing Center of North Carolina PLLC
• Brevard Hearing Center, LLC
• Brevard NC Opco LLC
• Brevard North Operating Al, LLC (Kingsbridge House)
• Brevard Orthopaedics, PA

• Community/Retail Pharmacy in Brevard, NC
• Providers in Brevard, 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 Aug 1, 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.