CMC-NORTHEAST, INC. (NPI# 1376798678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376798678 |
| Entity Type | Organization |
| Organization Name | CMC-NORTHEAST, INC. |
| Other Organization Name | PAVILION PHARMACY |
| Practice Address |
920 Church St N Concord NC 28025-2927 |
| Practice Telephone | 7044032079 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |
| Authorized Official Name | EVAN S FRASURE III (MANAGER, OUTPATIENT PHARMACY SERVIC) |
| Authorized Official Telephone | 7044032079 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
09822 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1376579052 | 01 | |
| NC | DEA | FP0600329 | 01 |
| Other Name | Type Code |
|---|---|
| Pavilion Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043525280 | Cmc-northeast, Inc. | Psychiatry & Neurology | 6600 Wilkinson Blvd, Carolinas Pediatric Neurology Care - Holy Angels, Belmont, NC 28012-2796 | 2010-08-12 |
| 1184777617 | Cmc-northeast, Inc. | Counselor | 105 Yadkin Street, Suite 302, Albemarle, NC 28001-3454 | 2007-01-19 |
| 1497716989 | Cmc-northeast, Inc. | Internal Medicine | 219 Le Phillip Ct Ne, Northeast Lung Associates, Concord, NC 28025-2900 | 2006-04-01 |
| 1841595121 | Cmc-northeast, Inc. | Pediatrics | 129 Woodson St, Suite C, Salisbury, NC 28144-3255 | 2011-01-19 |
| 1669777942 | Cmc-northeast, Inc. | Psychiatry & Neurology | 129 Woodson St, Suite B, Salisbury, NC 28144-3255 | 2011-01-19 |
| 1093010407 | Cmc-northeast, Inc. | Pediatrics | 129 Woodson St, Suite A, Salisbury, NC 28144-3255 | 2011-01-14 |
| 1972806321 | Cmc-northeast, Inc. | Psychiatry & Neurology | 1001 Blythe Blvd, Suite 200 Cpnc - Charlotte Specialty Center, Charlotte, NC 28203-5866 | 2010-12-07 |
| 1174823900 | Cmc-northeast, Inc. | Psychiatry & Neurology | 2550 Court Dr, Suite 203, Gastonia, NC 28054-2152 | 2010-10-27 |
| 1831407295 | Cmc-northeast, Inc. | Internal Medicine | 920 Church St N, Northeast Transition of Care, Concord, NC 28025-2927 | 2010-09-20 |
| 1033424270 | Cmc-northeast, Inc. | Psychiatry & Neurology | 1781 Tate Blvd Se, Carolinas Pediatric Neurology Care - Hickory, Hickory, NC 28602-4251 | 2010-08-12 |
| Street Address |
920 CHURCH ST N |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386647808 | Leanne Smith | Nurse Anesthetist, Certified Registered | 920 Church St N, Concord, NC 28025-2927 | 2005-05-30 |
| 1104431014 | Mrunmayee Manohar Shete | Genetic Counselor, MS | 920 Church St N, Concord, NC 28025-2927 | 2020-09-09 |
| 1083232144 | Sarah Elizabeth Garfinkle | Pharmacist | 920 Church St N, Concord, NC 28025-2927 | 2020-07-06 |
| 1184248924 | Dustin Edwards | Physician Assistant | 920 Church St N, Concord, NC 28025-2927 | 2020-06-06 |
| 1396372892 | Zaki Krishan Faraz Dard | Student in an Organized Health Care Education/Training Program | 920 Church St N, Concord, NC 28025-2927 | 2020-03-24 |
| 1477185825 | Tonda Vanderburg Proulx | Nurse Practitioner | 920 Church St N, Concord, NC 28025-2927 | 2020-02-04 |
| 1245870724 | Caroline A. Miller | Nurse Anesthetist, Certified Registered | 920 Church St N, Concord, NC 28025-2927 | 2020-01-13 |
| 1316585417 | Adam Beam | Nurse Anesthetist, Certified Registered | 920 Church St N, Concord, NC 28025-2927 | 2019-12-19 |
| 1114565496 | Kendal Brianne Mcmakin | Nurse Anesthetist, Certified Registered | 920 Church St N, Concord, NC 28025-2927 | 2019-12-17 |
| 1962053561 | Amanda Huneycutt Helms | Nurse Practitioner | 920 Church St N, Concord, NC 28025-2927 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326525551 | Genoa Healthcare, LLC | Pharmacy | 10 West St Ste P, Concord, NH 03301-3548 | 2018-07-20 |
| 1700385648 | Pharm90, LLC | Pharmacy | 1800 Monument Blvd Ste L, Concord, CA 94520-3871 | 2018-02-06 |
| 1619299146 | Kmart Corporation | Pharmacy | 545 Concord Pkwy N, Concord, NC 28027-6738 | 2010-02-25 |
| 1588991954 | Tsp First Health LLC | Pharmacy | 2030 Diamond Blvd, Concord, CA 94520-5702 | 2009-11-05 |
| 1912043829 | Modern Pharmacy | Pharmacy | 5 Clinton St, Concord, NH 03301-2303 | 2007-01-29 |
| 1609939438 | Geer Enterprises, Inc. | Pharmacy | 807 Davidson Dr Nw, Concord, NC 28025-4351 | 2006-12-19 |
| 1376642728 | Cvs Pharmacy Inc | Pharmacy | 199 Sudbury Rd, Concord, MA 01742-3466 | 2006-09-22 |
| 1295838977 | North Carolina Cvs Pharmacy LLC | Pharmacy | 931 Concord Pkwy N, Concord, NC 28027-5944 | 2006-09-07 |
| 1841300456 | Costco Wholesale Corporation | Pharmacy | 2400 Monument Blvd, Concord, CA 94520 | 2006-08-30 |
| 1922015924 | Walgreen Co | Pharmacy | 5230 Poplar Tent Rd, Concord, NC 28027-7757 | 2006-08-02 |
| Find all providers in CONCORD | ||||
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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.