Active NPI
Dameron Drug Store, Inc
- Clinic Pharmacy
- Tabor City, NC
National Provider Identifier
1962704635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic Pharmacy
- License
- 00917
- Legal business name
- DAMERON DRUG STORE, INC
- Practice address
- 100 S Main St
Tabor City, NC 28463-1910 - Phone
- (910) 653-3089
- Fax
- (910) 653-5839
- NPI assigned
- Dec 1, 2010
- Last updated
- Dec 1, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Fowler Lovett, PHARMD
- Title
- Pharmicist
- Phone
- (910) 653-3089
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | 00917 | NC | Primary |
Addresses
Primary practice location
100 S Main St
Tabor City, NC 28463-1910
Mailing address
100 S Main St
Tabor City, NC 28463-1910
Phone (910) 653-3089
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3411511 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 0245100 | Medicaid | NC | |
| 7N0917 | Medicaid | SC |
National Provider Directory
National Provider Directory- Tax ID family
- Dameron Drug Store Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Tabor City, NC
- NPI 1568509826
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.
-
- Pharmacist
- Tabor City, NC
- NPI 1043545841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291161600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1291161600000",
"number": "1962704635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S MAIN ST",
"city": "TABOR CITY",
"state": "NC",
"postal_code": "284631910",
"telephone_number": "910-653-3089",
"fax_number": "910-653-5839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S MAIN ST",
"city": "TABOR CITY",
"state": "NC",
"postal_code": "284631910",
"telephone_number": "910-653-3089",
"fax_number": "910-653-5839"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAMERON DRUG STORE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-12-01",
"last_updated": "2010-12-01",
"status": "A",
"authorized_official_last_name": "LOVETT",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "FOWLER",
"authorized_official_title_or_position": "PHARMICIST",
"authorized_official_telephone_number": "910-653-3089",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "NC",
"license": "00917",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "3411511",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0245100",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7N0917",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tabor City, NC
- Thomas E Coe, PAC
- Columbus Regional Health Network (South Columbus Medical Center)
- Columbus Regional Physicians Network (South Columbus Medical Center)
- Dameron Drug Store Inc (Dameron Discount Drugs Health Mart)
- Dameron Drug Store, Inc
- Morgan Elizabeth Dameron, PHARMD
- Bruce Anthony Dick Jr., FNP
- Iris J Evans, NP
- Generations Family Medicine
- Goshen Medical Center Incorporated
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.