LIVE OAKS OCTAGON (NPI# 1154778199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154778199 |
| Entity Type | Organization |
| Organization Name | LIVE OAKS OCTAGON |
| Other Organization Name | LIVE OAKS OCTAGON, LLC |
| Practice Address |
13521 Steelecroft Pkwy Charlotte NC 28278-7551 |
| Mailing Address |
13521 Steelecroft Pkwy Suite B Charlotte NC 28278-7551 |
| Practice Telephone | 6467297578 |
| Practice Fax Number | 9802564715 |
| Mailing Telephone | 6467297578 |
| Mailing Fax Number | 9802564715 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-08-02 |
| Authorized Official Name | TOM MULLEN (MANAGER) |
| Authorized Official Telephone | 6467297578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2160273 | 01 |
| Other Name | Type Code |
|---|---|
| Live Oaks Octagon, LLC | Doing Business As Name - Organization |
| Street Address |
13521 STEELECROFT PKWY |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28278-7551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992904155 | Stephanie Lynn Jackson | Dentist | 13521 Steelecroft Pkwy, Suite 100, Charlotte, NC 28278-7545 | 2007-07-17 |
| 1558979021 | Austin Michael Hanna | Nurse Practitioner | 13521 Steelecroft Pkwy, Charlotte, NC 28278-7551 | 2020-07-21 |
| 1467999003 | Yvette Walker | Nurse Practitioner | 13521 Steelecroft Pkwy, Charlotte, NC 28278-7551 | 2017-01-20 |
| 1417391004 | Clear View Eye Care Od Pa | Optometrist | 13521 Steelecroft Pkwy, Suite B, Charlotte, NC 28278-7545 | 2013-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366060170 | Stride | Community/Behavioral Health | 14054 Singleleaf Lane, Charlotte, NC 28278 | 2020-07-08 |
| 1245742279 | Ruby Home Healthcare, LLC | Home Health | 17202 Belmont Stakes Lane, Charlotte, NC 28278 | 2017-10-31 |
| 1962926287 | Limitless Little Learners | Community/Behavioral Health | 13909 Derby Farm Lane, Charlotte, NC 28278 | 2017-07-28 |
| 1497106694 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 4821 Berewick Town Center Dr, Charlotte, NC 28278 | 2016-06-29 |
| 1932574753 | Adrienne Forney | Counselor | 14923 Alyssa Faith Court, Charlotte, NC 28278 | 2015-12-04 |
| 1447620398 | Sherae Threatt Lattimore | Behavioral Analyst | 5614 Samuel Neel Rd, Charlotte, NC 28278 | 2015-10-05 |
| 1528340676 | Khyati Dhaval Shah | Pediatrics | 13557 Steelecroft Pkwy Ste 2200, Charlotte, NC 28278 | 2011-09-14 |
| 1184915043 | John Angelo Tenini | Internal Medicine | 13557 Steelecroft Pkwy Ste 1200, Charlotte, NC 28278 | 2011-04-27 |
| 1568612240 | Kim Marie Briden | Contractor | 13805 Appling Lane, Charlotte, NC 28278 | 2008-09-30 |
| 1144477258 | Presbyterian Imaging Centers LLC | Radiology | 13557 Steelecroft Parkway, Suite 1100, Charlotte, NC 28278 | 2008-08-20 |
| Find all providers in zip 28278 | ||||
| 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] |
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|---|---|---|---|---|
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| 1245841279 | Novant Health Pharmacy Services, LLC | Pharmacy | 125 Queens Rd Ste 180, Charlotte, NC 28204-3215 | 2020-08-13 |
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1942863832 | Ndvs Drugs, Inc. | Pharmacy | 5820 E W T Harris Blvd Ste E2, Charlotte, NC 28215-4559 | 2019-04-17 |
| 1053856419 | Central Pharmacy - Charlotte LLC | Pharmacy | 354 S Cochran Ave Ste 3, Charlotte, MI 48813-1569 | 2016-12-21 |
| 1639559966 | Star Bright Pharmacy Inc. | Pharmacy | 231 Mt Holly Huntersville Rd, Ste 160, Charlotte, NC 28214-9357 | 2015-06-02 |
| 1487047874 | Lax Group LLC | Pharmacy | 8035 Providence Rd Ste 100, Charlotte, NC 28277-9716 | 2015-03-10 |
| 1851718571 | Friendly Family Pharmacy, LLC Dba Friendly Family Pharmacy Paw Creek | Pharmacy | 517 Little Rock Rd, Charlotte, NC 28214-1915 | 2014-03-19 |
| 1932521416 | Charlotte-mecklenburg Hospital Authority | Pharmacy | 4400 Golf Acres Dr Ste F, Charlotte, NC 28208-5990 | 2014-01-17 |
| 1740613140 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Rd Ste H, Charlotte, NC 28210-7429 | 2013-08-21 |
| Find all providers in CHARLOTTE | ||||
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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.