Active NPI
Samantha Joanna Faye Deloache, PHARM D
- Pharmacist
- Gastonia, NC
National Provider Identifier
1972822765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19346
- Practice address
- 991 W Hudson Blvd
Gastonia, NC 28052-6430 - Phone
- (704) 853-5086
- NPI assigned
- May 19, 2010
- Last updated
- May 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19346 | NC | Primary |
| Pharmacist | 183500000X | 11998 | SC | |
| Pharmacist | 183500000X | 0202208199 | VA |
Addresses
Primary practice location
991 W Hudson Blvd
Gastonia, NC 28052-6430
Mailing address
5416 Talus Trace LN
Charlotte, NC 28215-4132
Phone (803) 707-2510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202208199 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1972822765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5416 TALUS TRACE LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282154132",
"telephone_number": "803-707-2510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "991 W HUDSON BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280526430",
"telephone_number": "704-853-5086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELOACHE",
"first_name": "SAMANTHA",
"middle_name": "JOANNA FAYE",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "19346",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "11998",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202208199",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
- Christopher A Degeorge, D.C.
- Chastity Louise Degree, LCSWA
- Lesia Maria Delgado
- Jordan T Delk, PA-C
- Jennie Marie Dellinger, P.A.
- Brent Delong, DDS
- Robert Eldridge Delozier, MSN, PMHNP-BC
- Delta Healthcare Management (Heritage Oaks Assisted Living)
- Philip Joseph Deluca, LCSW
- Pauline Demonico, LCAS, CCS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.