REVIVAL A DEPARTMENT OF NORTHERN HOSPITAL
NPI 1588099022
Pharmacy - Clinic Pharmacy in Elkin, NC
NPI Status: Active since September 03, 2013
Contact Information
110 DUTCHMAN CT
ELKIN, NC
ZIP 28621
Phone: (336) 835-5330
Fax: (336) 526-1399
- Organization
- Pharmacy
- Clinic Pharmacy
- Accepts Insurance
- CLIA Number: 34D2182703
- CLIA Cert. Type: Other - URGENT CARE CENTER
- CLIA Exp. Date: 04-23-2026
About REVIVAL A DEPARTMENT OF NORTHERN HOSPITAL
This page provides the complete NPI Profile along with additional information for Revival A Department Of Northern Hospital, a provider established in Elkin, North Carolina operating as a Pharmacy, focusing in clinic pharmacy . The healthcare provider is registered in the NPI registry with number 1588099022 assigned on September 2013. The practitioner's primary taxonomy code is 3336C0002X with license number 11612 (NC). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Revival A Department Of Northern Hospital. The authorized official of this NPI record is Mrs. Robin Hodgin Rn, Mha (V. President Of Patient Services &)
- NPI
- 1588099022
- Provider Legal Name
- NORTHERN HOSPITAL OF SURRY COUNTY
- Other Organization Name
- REVIVAL A DEPARTMENT OF NORTHERN HOSPITAL
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 110 DUTCHMAN CT ELKIN, NC 28621
- Location Phone
- (336) 835-5330
- Location Fax
- (336) 526-1399
- Mailing Address
- PO BOX 1101 MOUNT AIRY, NC 27030
- Mailing Phone
- (336) 719-7000
- Mailing Fax
- (336) 526-1399
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-03-2013
- Last Update Date
- 03-09-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Clinic Pharmacy
- Taxonomy Code
- 3336C0002X
- Type
- Suppliers
- License No.
- 11612
- License State
- NC
- Taxonomy Description
- A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Select by Medica Bronze $0 Copay PCP Visits - EPO
- Select by Medica Bronze Share - EPO
- Select by Medica Expanded Bronze Standard - EPO
- Select by Medica Gold $0 Copay PCP Visits - EPO
- Select by Medica Gold Share - EPO
- Select by Medica Gold Standard - EPO
- Select by Medica Silver $0 Copay PCP Visits - EPO
- Select by Medica Silver Share - EPO
- Select by Medica Silver Standard - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 89132UV | MEDICAID (05) | NC | |
| 2141874 | OTHER (01) | PK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2182703
- Facility Type
- Other - URGENT CARE CENTER
- Certificate Effective Date
- April 24, 2024
- Certificate Expiration Date
- April 23, 2026
- Laboratory Director
- MARK LEGOLVAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Revival A Department Of Northern Hospital to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for REVIVAL A DEPARTMENT OF NORTHERN HOSPITAL
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1588099022, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
ELKIN, NC 28621
ELKIN, NC 28621
ELKIN, NC 28621
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1588099022, enumerated as an "organization" on September 03, 2013.
The provider is located at 110 DUTCHMAN CT ELKIN, NC 28621 and the phone number is (336) 835-5330.
Pharmacy with taxonomy code 3336C0002X and a focus in Clinic Pharmacy.
The provider might be accepting Accepts: Medica, Moda Health Plan, Inc., Medicare and. Please consult your insurance carrier or call the provider to verify.
