Organization Active NPI

Greensboro Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Greensboro, MD
National Provider Identifier
1841332202
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P00353 Issued in MD
Legal business name
GREENSBORO PHARMACY, INC.
Practice address
102 S Main St
Greensboro, MD 21639-0490
Phone
(410) 482-6256
Fax
(410) 482-2469
NPI assigned
Feb 13, 2007
Last updated
Sep 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Mrs. Michele Teresa Clough, RPHNPI 1427636794
Title
Owner
Phone
(410) 482-6256

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P00353 MD Primary

Addresses

Primary practice location

102 S Main St
Greensboro, MD 21639-0490

Mailing address

102 S Main St
PO Box 490
Greensboro, MD 21639-0490
Phone (410) 482-6256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20201218000782 MD Part B Supplier - Mass Immunization (Roster Biller Only) 1557773371 Practice locations: Greensboro, MD
O20201221001189 MD Part B Supplier - Pharmacy 1557773371 Practice locations: Greensboro, MD
O20210607001596 MD Part B Supplier - Independent Clinical Laboratory 1557773371 Practice locations: Greensboro, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2188386Greensboro Pharmacy102 S Main Street, Greensboro, MD 21639Certificate of waiverJul 15, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1841332202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S MAIN ST",
            "address_2": "PO BOX 490",
            "city": "GREENSBORO",
            "state": "MD",
            "postal_code": "216390490",
            "telephone_number": "410-482-6256",
            "fax_number": "410-482-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S MAIN ST",
            "city": "GREENSBORO",
            "state": "MD",
            "postal_code": "216390490",
            "telephone_number": "410-482-6256",
            "fax_number": "410-482-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENSBORO PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "CLOUGH",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-482-6256",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P00353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.