MEDICARE: 501 PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	13062	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2165970	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275088320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	501 PHARMACY LLC

Provider Business Mailing Address
First Line	:	69 KNOX WAY STE 110
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-6619
Country	:	US
Telephone Number	:	984-999-0501
Fax Number	:	984-999-0502

Provider Business Practice Location Address
First Line	:	69 KNOX WAY STE 110
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-6619
Country	:	US
Telephone Number	:	984-999-0501
Fax Number	:	984-999-0502

Authorized Official
Title or Position	:	OWNER
Name	:	GREGORY VASSIE
Credential	:
Telephone Number	:	984-999-0501

Provider Enumeration Date	:	08/18/2016
Last Update Date	:	09/19/2025

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