Organization Active NPI

The Moses H. Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Greensboro, NC
National Provider Identifier
1982004289
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12080 Issued in NC
Legal business name
THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Practice address
201 E Wendover Ave
Greensboro, NC 27401-1205
Phone
(336) 832-3630
Fax
(336) 832-3632
NPI assigned
Aug 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Courtney Blackwell Isom, PHARMD
Title
Pharmacy Manager
Phone
(336) 832-3631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 12080 NC Primary

Addresses

Primary practice location

201 E Wendover Ave
Greensboro, NC 27401-1205

Mailing address

201 E Wendover Ave
Greensboro, NC 27401-1205
Phone (336) 832-3630

Other names 1

  • Community Health and Wellness Center Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130522000385 NC Part B Supplier - Pharmacy 6204744600 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asheboro, NC; Eden, NC; Greensboro, NC; High Point, NC

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1982004289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011205",
            "telephone_number": "336-832-3630",
            "fax_number": "336-832-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011205",
            "telephone_number": "336-832-3630",
            "fax_number": "336-832-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-25",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "ISOM",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "BLACKWELL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "336-832-3631",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health and Wellness Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Health and Wellness Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.