OLD MAIN PHARMACY INC (NPI# 1013152099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013152099 |
| Entity Type | Organization |
| Organization Name | OLD MAIN PHARMACY INC |
| Other Organization Name | OLD MAIN PHARMACY |
| Practice Address |
407 W 3rd St Pembroke NC 28372-7977 |
| Mailing Address |
Po Box 2639 Pembroke NC 28372-2639 |
| Practice Telephone | 9105225500 |
| Practice Fax Number | 9108443017 |
| Mailing Telephone | 9105215600 |
| Mailing Fax Number | 9105211906 |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | JUSTIN DANIEL (PRESIDENT/OWNER) |
| Authorized Official Telephone | 9105215600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 11213 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2143626 | 01 |
| Other Name | Type Code |
|---|---|
| Old Main Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417205410 | Old Main Pharmacy Inc | Pharmacy | 101 S Bond St, Rowland, NC 28383-9639 | 2012-08-22 |
| Street Address |
407 W 3RD ST |
| City | PEMBROKE |
| State | NC |
| Zip Code | 28372-7977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013538404 | Colin Lee Lowery | Pharmacist | 407 W 3rd St, Pembroke, NC 28372-7977 | 2020-04-27 |
| 1821535816 | Rowland Old Main Inc | Pharmacy | 407 W 3rd St, Pembroke, NC 28372-7977 | 2017-01-27 |
| 1790029304 | Genia Renae Locklear | Orthotic Fitter | 407 W 3rd St, Pembroke, NC 28372-7977 | 2012-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962977 | Kayla J Oxendine | Counselor | 86 Threehunts Drive, Pembroke, NC 28372 | 2020-11-03 |
| 1720688401 | Melissa Claire Kratz | Pharmacist | 930 Hwy 711 East, Pembroke, NC 28372 | 2020-10-30 |
| 1841775681 | Nikki Locklear | Counselor | 86 Three Hunts Dr., Pembroke, NC 28372 | 2018-09-27 |
| 1043703218 | Julie Anne Harrison-swartz | Nurse Practitioner | Uncp Student Health, 113 Hawk Drive, Pembroke, NC 28372 | 2018-06-12 |
| 1134627508 | William Dixon | Specialist/Technologist | One University Drive, Pembroke, NC 28372 | 2018-01-31 |
| 1740796291 | A Primary Choice, Inc. | In Home Supportive Care | 208 Union Chapel Road, Suite D, Pembroke, NC 28372 | 2017-12-20 |
| 1578924130 | William Joshua Johnson | Nurse Practitioner | 3334 Moss Neck Road, Pembroke, NC 28372 | 2016-03-10 |
| 1831560234 | Sungjun Jung | Pharmacist | 930 Nc Hwy 711 E, Pembroke, NC 28372 | 2015-10-12 |
| 1154715027 | Lilly Marie Shorter | Counselor | 86 Three Hunt Drive, Pembroke, NC 28372 | 2015-03-27 |
| 1487046728 | Eye Heart You Home Health, LLC | Public Health or Welfare | 925 University Road, Pembroke, NC 28372 | 2015-02-24 |
| Find all providers in zip 28372 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912428616 | Scotland Memorial Hospital Inc | Pharmacy | 410 D South Jones St, Pembroke, NC 28372-7261 | 2017-07-03 |
| 1366573297 | Malken Pharm Services Inc | Pharmacy | 137 E. Bacon St, Pembroke, GA 31321 | 2007-03-09 |
| 1588115463 | Pembroke Drug Holdings, LLC | Pharmacy | 205 W 3rd St, Pembroke, NC 28372-8768 | 2016-10-17 |
| 1568572261 | Kerr Drug Inc | Pharmacy | 503 E 3rd St, Pembroke, NC 28372-7989 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163135 | Bl Apothecary | Pharmacy | 2739 W 5th St, Lumberton, NC 28358-7819 | 2020-10-31 |
| 1730795873 | Vaxclinic, LLC | Pharmacy | 4400 Park Rd Ste 316, Charlotte, NC 28209-3289 | 2020-09-22 |
| 1720692908 | Geriatrx | Pharmacy | 1655 Snowmass Way, Durham, NC 27713-4514 | 2020-09-03 |
| 1245841279 | Novant Health Pharmacy Services, LLC | Pharmacy | 125 Queens Rd Ste 180, Charlotte, NC 28204-3215 | 2020-08-13 |
| 1912516287 | Pinetops Pharmacy, Inc. | Pharmacy | 102 W. Hamlet St, Pinetops, NC 27864 | 2020-07-23 |
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1629618285 | Dalia Zaghlool | Pharmacy | 4353 Milhaven Park Ln, Winston Salem, NC 27106-4970 | 2020-01-12 |
| 1770123887 | Scotland Memorial Hospital Inc | Pharmacy | 700 Progress Pl, Laurinburg, NC 28352-5545 | 2020-01-07 |
| 1194361832 | Realo Veterinary Pharmacy Inc | Pharmacy | 3800 Gateway Centre Blvd Ste 308a, Morrisville, NC 27560-6220 | 2019-11-18 |
| 1952946246 | Emily Hodges Hall | Pharmacy | 627 E 12th Street, Washington, NC 27889 | 2019-11-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.