Organization Active NPI

Windsor Point Pharmacy, Inc.

  • Long Term Care Pharmacy
  • Fuquay Varina, NC
National Provider Identifier
1962549055
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
07118 Issued in NC
Legal business name
WINDSOR POINT PHARMACY, INC.
Practice address
1221 Broad St
Fuquay Varina, NC 27526-3602
Phone
(919) 567-0220
Fax
(919) 567-2057
NPI assigned
Jan 30, 2007
Last updated
Sep 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Mrs. Michelle H Avant
Title
Accountant
Phone
(919) 577-0035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 07118 NC Primary

Addresses

Primary practice location

1221 Broad St
Fuquay Varina, NC 27526-3602

Mailing address

1221 Broad St
Fuquay Varina, NC 27526-3602
Phone (919) 567-0220

Other identifiers 1

IdentifierTypeStateIssuer
0920497MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210430001419 NC Part B Supplier - Mass Immunization (Roster Biller Only) 0143493197 Practice locations: Clayton, NC

National Provider Directory

National Provider Directory

Locations

581 Guy Rd
Ste 102
Clayton, NC 27520
Phone (919) 359-0499

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Windsor Point Inc CCRCFuquay-Varina, NC, CCN 345500 Skilled nursing facility Adp of the SNF Mar 28, 1998

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1962549055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 BROAD ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263602",
            "telephone_number": "919-567-0220",
            "fax_number": "919-567-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 BROAD ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263602",
            "telephone_number": "919-567-0220",
            "fax_number": "919-567-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR POINT PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "AVANT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "919-577-0035",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "07118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0920497",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.