Innes Street Drug Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

05609 Issued in NC

Legal business name

INNES STREET DRUG COMPANY

Doing business as

INNES STREET DRUG COMPANY

Practice address

1706 W Innes St
Salisbury, NC 28144-2552

Phone

(704) 636-1712

Fax

(704) 637-0324

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

James Fuller

Title

President Owner

Phone

(704) 636-1712

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• INNES STREET DRUG COMPANY Doing business as

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1912949710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4065",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281454065",
            "telephone_number": "704-633-4521",
            "fax_number": "704-633-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W INNES ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442552",
            "telephone_number": "704-636-1712",
            "fax_number": "704-637-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNES STREET DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "704-636-1712"
    },
    "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": "05609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805473",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2067260",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INNES STREET DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.