NPIMap

Organization Active NPI

Realo Discount Drug Stores of Eastern North Carolina Inc

Doing business as Realo Extended Care Pharmacy

  • Long Term Care Pharmacy
  • New Bern, NC
National Provider Identifier
1841611167
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC
Doing business as
Realo Extended Care Pharmacy
Practice address
2129 S Glenburnie Rd
Suite 12 South Market Square
New Bern, NC 28562-5267
Phone
(252) 672-0253
Fax
(252) 514-0180
NPI assigned
Jan 6, 2014
Last updated
Jan 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Authorized official

Name
Mr. Robert Joseph McLaughlin Jr., RPH
Title
President
Phone
(252) 639-9006

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

2129 S Glenburnie Rd
Suite 12 South Market Square
New Bern, NC 28562-5267

Mailing address

1301 Commerce Dr
New Bern, NC 28562-2213
Phone (252) 639-9006

Other identifiers 2

IdentifierTypeStateIssuer
11793OtherNCNORTH CAROLINA BOARD OF PHARMACY
1841611167MedicaidNC

Other names 1

  • Realo Extended Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140829000357 NC DME Supplier - Pharmacy 7618995986 Practice locations: New Bern, NC
O20190619003357 NC Part B Supplier - Pharmacy 7618995986 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beulaville, NC; New Bern, NC; Wilson, NC

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2129 S Glenburnie Rd
Ste 12
New Bern, NC 28562
Phone (252) 672-0253

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1841611167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 COMMERCE DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622213",
            "telephone_number": "252-639-9006",
            "fax_number": "252-639-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 S GLENBURNIE RD",
            "address_2": "SUITE 12 SOUTH MARKET SQUARE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625267",
            "telephone_number": "252-672-0253",
            "fax_number": "252-514-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALO DISCOUNT DRUG STORES OF EASTERN NORTH CAROLINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-06",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-639-9006",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF PHARMACY",
            "identifier": "11793",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841611167",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Realo Extended Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.

Verify at the official NPI Registry.