NPIMap

Organization Active NPI

Pharmaceutical Specialties Inc

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1932213634
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
07602 Issued in NC
Legal business name
PHARMACEUTICAL SPECIALTIES INC
Practice address
756 Tyvola Rd Ste 112a
Charlotte, NC 28217-3535
Phone
(704) 519-0617
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Keith Sledge, R.PH
Title
Owner/Pharmacist
Phone
(704) 519-0617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 07602 NC Primary

Addresses

Primary practice location

756 Tyvola Rd Ste 112a
Charlotte, NC 28217-3535

Mailing address

756 Tyvola Rd Ste 112a
Charlotte, NC 28217-3535
Phone (704) 519-0617

Other identifiers 1

IdentifierTypeStateIssuer
0609367MedicaidNC

Other names 1

  • Pharmacuatical Specialtie NC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pharmaceutical Specialties Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

756 Tyvola Rd
Ste 112A
Charlotte, NC 28217
Phone (646) 270-2269

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932213634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 TYVOLA RD STE 112A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173535",
            "telephone_number": "704-519-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 TYVOLA RD STE 112A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173535",
            "telephone_number": "704-519-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACEUTICAL SPECIALTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLEDGE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "704-519-0617",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "07602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0609367",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacuatical Specialtie NC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.