NPIMap

Organization Active NPI

Greenbrier Medical Arts Pharmacy Inc

  • Community/Retail Pharmacy
  • Lewisburg, WV
National Provider Identifier
1992708770
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
SP0550581 Issued in WV
Legal business name
GREENBRIER MEDICAL ARTS PHARMACY INC
Practice address
690 Maplewood Ave
Lewisburg, WV 24901-9300
Phone
(304) 647-5121
Fax
(304) 647-5122
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Erin Hager
Title
Corporate Office Manager
Phone
(304) 645-5547

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X SP0550581 WV Primary

Addresses

Primary practice location

690 Maplewood Ave
Lewisburg, WV 24901-9300

Mailing address

3558 Jefferson St N Ste 1
Lewisburg, WV 24901-5730
Phone (304) 645-5547

Other identifiers 3

IdentifierTypeStateIssuer
1992708770MedicaidVA
0141908000MedicaidWV
2110013OtherPK

Other names 1

  • GREENBRIER MEDICAL ARTS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061017000229 WV Part B Supplier - Mass Immunization (Roster Biller Only) 1759387624 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lewisburg, WV; Ronceverte, WV; Union, WV; White Sulphur Springs, WV
O20100930014856 WV DME Supplier - Pharmacy 1759387624 Practice locations: Lewisburg, WV

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Greenbrier Medical Arts Pharmacy in690 Maplewood Ave, Lewisburg, WV 24901-9300(304) 647-5121 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Orthoses: Off-The-Shelf|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 2006

National Provider Directory

National Provider Directory
Tax ID family
Greenbrier Medical Arts Pharmacy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

690 Maplewood Ave
Lewisburg, WV 24901
Phone (304) 647-5121

128 Community Ln
White Sulphur Springs, WV 24986
Phone (304) 536-2454

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1992708770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 JEFFERSON ST N STE 1",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249015730",
            "telephone_number": "304-645-5547",
            "fax_number": "304-645-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MAPLEWOOD AVE",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019300",
            "telephone_number": "304-647-5121",
            "fax_number": "304-647-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIER MEDICAL ARTS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "HAGER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CORPORATE OFFICE MANAGER",
        "authorized_official_telephone_number": "304-645-5547"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0550581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992708770",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141908000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110013",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREENBRIER MEDICAL ARTS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREENBRIER MEDICAL ARTS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.