Rock Drug of Valdese LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11094 Issued in NC

Legal business name

ROCK DRUG OF VALDESE LLC

Doing business as

Rock Drug Store

Practice address

240 Main St W
Valdese, NC 28690-2835

Phone

(828) 879-9812

Fax

(828) 874-8915

NPI assigned

Oct 20, 2006

Last updated

Jun 9, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Bruce Cannon, RPH--MGR LLC

Title

Manager LLC

Phone

(828) 879-9812

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rock Drug Store Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Cannon Drug Co

  dba Cannon Pharmacy

  • Community/Retail Pharmacy
  • Morganton, NC
  • NPI 1285732412

  Member Of

  NPD member

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.

• Ronald L. Fulmer, RPH

  • Pharmacist
  • Valdese, NC
  • NPI 1316154933
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1962584755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "address_2": "240 MAIN ST WEST",
            "city": "VALDESE",
            "state": "NC",
            "postal_code": "286902835",
            "telephone_number": "828-879-9812",
            "fax_number": "828-874-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAIN ST W",
            "city": "VALDESE",
            "state": "NC",
            "postal_code": "286902835",
            "telephone_number": "828-879-9812",
            "fax_number": "828-874-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK DRUG OF VALDESE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "MANAGER LLC",
        "authorized_official_telephone_number": "828-879-9812",
        "authorized_official_credential": "RPH--MGR LLC"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3411725",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bethany Morgan Queen
• Rare Thearpy
• Reynolds Family Wellness Center
• Paula Gruensfelder Reynolds, D.C.
• David Forrest Richards, PH.D., BCBA, LP
• Rock Drug of Valdese, LLC (Rock Drug Store)
• S & J Medical (The Wheelchair Company)
• Annette Lambert Skidmore, MA, CCC-SLP
• Spark Counseling and Behavioral Services PLLC
• Lauren Cobb Speight, MS, CCC-SLP

• Community/Retail Pharmacy in Valdese, NC
• Providers in Valdese, 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 Jun 9, 2014; 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.