NPIMap

Organization Active NPI

Family Care Pharmacy of Jacksonville

  • Community/Retail Pharmacy
  • Jacksonville, NC
National Provider Identifier
1831574367
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10242 Issued in NC
Legal business name
FAMILY CARE PHARMACY OF JACKSONVILLE
Practice address
114 Memorial Dr
Suite B
Jacksonville, NC 28546-6328
Phone
(910) 353-5050
Fax
(910) 238-4659
NPI assigned
Jul 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Authorized official

Name
Amy KingNPI 1144605874
Title
Pharmacy Manager/President
Phone
(910) 353-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 10242 NC
Community/Retail Pharmacy 3336C0003X 10242 NC Primary

Addresses

Primary practice location

114 Memorial Dr
Suite B
Jacksonville, NC 28546-6328

Mailing address

114 Memorial Dr
Suite B
Jacksonville, NC 28546-6328
Phone (910) 353-5050

Other identifiers 2

IdentifierTypeStateIssuer
7705209MedicaidNC
0675695MedicaidNC

National Provider Directory

National Provider Directory

Locations

114 Memorial Dr
#B
Jacksonville, NC 28546
Phone (910) 353-5050

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1831574367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MEMORIAL DR",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-5050",
            "fax_number": "910-238-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MEMORIAL DR",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-5050",
            "fax_number": "910-238-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE PHARMACY OF JACKSONVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PHARMACY MANAGER/PRESIDENT",
        "authorized_official_telephone_number": "910-353-5050"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "10242",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7705209",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0675695",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.