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OLD MAIN PHARMACY
NPI 1013152099
Pharmacy in Pembroke, NC

Active since December 05, 2008CLIA 34D2232342 · Waiver
407 W 3RD ST, PEMBROKE, NC 28372(910) 522-5500(910) 844-3017 Get Directions Write a Review

NPPES record last updated: February 20, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Old Main Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLD MAIN PHARMACY (NPI 1013152099) is a healthcare organization registered as a pharmacy in Pembroke, North Carolina and active in the NPI registry since December 2008. The organization holds a CLIA Waiver certificate valid through August 11, 2027 and lists Justin Daniel, President/owner, as its authorized official.

NPPES Registry Identity

NPI1013152099
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameOLD MAIN PHARMACY INC
Location Address407 W 3RD STPembroke, NC 28372-7977
Mailing AddressPo Box 2639Pembroke, NC 28372-2639 · (910) 521-5600 · Fax (910) 521-1906
Phone(910) 522-5500
Fax(910) 844-3017
Organization SubpartNo
Authorized OfficialJustin DanielPresident/owner · (910) 521-5600
Enumeration DateDecember 5, 2008
Last NPPES UpdateFebruary 20, 2017
✔ NPI 1013152099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NC · 11213
Definition
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.
407 W 3RD ST, Pembroke, NC 28372
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Other Names 1

Doing Business AsOld Main Pharmacy

Other Identifiers 1

Other2143626Pk

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2232342

Old Main Pharmacy · Pembroke, NC
Active · expires Aug 11, 2027
CLIA Number34D2232342
Laboratory TypePharmacy
Certificate Effective DateAugust 12, 2025
Certificate Expiration DateAugust 11, 2027
Laboratory DirectorAmber Locklear
Laboratory Phone(910) 521-5600
Laboratory LocationOld Main Pharmacy407 West Third Street, Pembroke, NC 28372
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. COLIN LEE LOWERY PHARMD.
Pharmacist
407 W 3RD ST
PEMBROKE, NC 28372
Robeson County (910) 521-5600
ROWLAND OLD MAIN, INC.
Pharmacy (Long Term Care Pharmacy)
407 W 3RD ST
PEMBROKE, NC 28372
Robeson County (105) 215-6009
MRS. GENIA RENAE LOCKLEAR CFTS
Orthotic Fitter
407 W 3RD ST
PEMBROKE, NC 28372
Robeson County (910) 521-5600
ROWLAND OLD MAIN INC
Pharmacy
407 W 3RD ST
PEMBROKE, NC 28372
Robeson County (910) 522-5500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Old Main Pharmacy Inc's NPI number?

The NPI number for Old Main Pharmacy Inc is 1013152099. It was assigned to this organization in the NPPES registry on December 5, 2008. The provider is doing business as Old Main Pharmacy.

Where is Old Main Pharmacy Inc located?

Old Main Pharmacy Inc is located at 407 W 3rd St, Pembroke, NC 28372. The listed phone number is (910) 522-5500.

What is Old Main Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Old Main Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2232342) is associated with this NPI, valid through August 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Old Main Pharmacy Inc was last updated on February 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.