NPIMap

Organization Active NPI

Two Rivers Pharmacy Inc

  • Community/Retail Pharmacy
  • Fayetteville, NC
National Provider Identifier
1891160008
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12778 Issued in NC
Legal business name
TWO RIVERS PHARMACY INC
Practice address
101 Broadfoot Ave
Fayetteville, NC 28305-5001
Phone
(910) 748-0243
Fax
(910) 748-0245
NPI assigned
Dec 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
James Deese
Title
PM/Owner
Phone
(910) 734-4896

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 12778 NC Primary

Addresses

Primary practice location

101 Broadfoot Ave
Fayetteville, NC 28305-5001

Mailing address

101 Broadfoot Ave
Fayetteville, NC 28305-5001
Phone (910) 483-5450

Other identifiers 1

IdentifierTypeStateIssuer
2155961OtherPK

Other names 1

  • Two Rivers Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Two Rivers Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1891160008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BROADFOOT AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055001",
            "telephone_number": "910-483-5450",
            "fax_number": "910-483-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROADFOOT AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055001",
            "telephone_number": "910-748-0243",
            "fax_number": "910-748-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "DEESE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PM/OWNER",
        "authorized_official_telephone_number": "910-734-4896"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155961",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Two Rivers Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.