NPIMap

Organization Active NPI

DDP Pharmacy, Inc

  • Durable Medical Equipment & Medical Supplies
  • Roanoke Rapids, NC
National Provider Identifier
1881648442
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
05053 Issued in NC
Legal business name
DDP PHARMACY, INC
Practice address
107 Smith Church Rd
Roanoke Rapids, NC 27870-4911
Phone
(252) 537-7010
Fax
(252) 410-0743
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Mr. Bryan S Isles
Title
General Manager
Phone
(252) 537-7010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 05053 NC Primary

Addresses

Primary practice location

107 Smith Church Rd
Roanoke Rapids, NC 27870-4911

Mailing address

107 Smith Church Rd
Roanoke Rapids, NC 27870-4911
Phone (252) 537-7010

Other identifiers 1

IdentifierTypeStateIssuer
7700278MedicaidNC

Other names 1

  • DRUGCO DISCOUNT PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930026666 NC DME Supplier - PharmacyDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply Company With Respiratory Therapist 5193897882 Practice locations: Roanoke Rapids, NC

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
DDP Pharmacy Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1881648442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704911",
            "telephone_number": "252-537-7010",
            "fax_number": "252-410-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704911",
            "telephone_number": "252-537-7010",
            "fax_number": "252-410-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DDP PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "ISLES",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "252-537-7010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "05053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700278",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DRUGCO DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.