Organization Active NPI

Gaben

  • Community/Retail Pharmacy
  • Knightdale, NC
National Provider Identifier
1851660807
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
11174 Issued in NC
Legal business name
GABEN
Practice address
6602 Knightdale Blvd
Suite 120
Knightdale, NC 27545-6525
Phone
(919) 295-1112
Fax
(919) 295-1164
NPI assigned
Dec 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Segmia Kenna Tohnya, PHARM.D.NPI 1811155807
Title
Pharmacy Director
Phone
(443) 621-4271

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 11174 NC Primary

Addresses

Primary practice location

6602 Knightdale Blvd
Suite 120
Knightdale, NC 27545-6525

Mailing address

6602 Knightdale Blvd
Suite 120
Knightdale, NC 27545-6525
Phone (919) 295-1112

Other names 1

  • Knightdale Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131014001478 NC Part B Supplier - Mass Immunization (Roster Biller Only) 9032373857 Practice locations: Knightdale, NC

National Provider Directory

National Provider Directory

Locations

6602 Knightdale Blvd
Ste 120
Knightdale, NC 27545
Phone (919) 295-1112

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": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1851660807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 KNIGHTDALE BLVD",
            "address_2": "SUITE 120",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456525",
            "telephone_number": "919-295-1112",
            "fax_number": "919-295-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 KNIGHTDALE BLVD",
            "address_2": "SUITE 120",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456525",
            "telephone_number": "919-295-1112",
            "fax_number": "919-295-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "TOHNYA",
        "authorized_official_first_name": "SEGMIA",
        "authorized_official_middle_name": "KENNA",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "443-621-4271",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knightdale Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.