Specialty Pharmacy-Southern Pines LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10686 Issued in NC

Legal business name

SPECIALTY PHARMACY-SOUTHERN PINES LLC

Practice address

735 S. Bennett St.
Southern Pines, NC 28387

Phone

(910) 246-9355

Fax

(910) 246-1755

NPI assigned

Nov 30, 2010

Organization subpart

No

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

Authorized official

Name

Wesley Waters

Title

President

Phone

(910) 691-1022

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Specialty Pharmacy-Southern Pines, LLC Doing business as

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1962704775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 S BENNETT ST",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875921",
            "telephone_number": "910-246-9355",
            "fax_number": "910-246-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 S. BENNETT ST.",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "28387",
            "telephone_number": "910-246-9355",
            "fax_number": "910-246-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHARMACY-SOUTHERN PINES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-691-1022"
    },
    "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": "10686",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3458191",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Pharmacy-Southern Pines, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Pines Prescription Shop Inc
• Southern Pines Surgery Center, LLC
• Southern Pines Women'S Health Center PC
• Southern Speech Diagnostics PLLC
• Ashley M Sparks, LCSW-A
• Cassandra Nicole Spencer, MS, OTR/L
• Stefany Sproul
• Precious C Squalls
• St. Joseph of the Pines, Inc
• Mark Austin Stanley

• Community/Retail Pharmacy in Southern Pines, NC
• Providers in Southern Pines, 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 Mar 11, 2013; 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.