Flint River Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHRE010139 Issued in GA

Legal business name

FLINT RIVER PHARMACY LLC

Practice address

506-C Spaulding Road
Montezuma, GA 31063-1804

Phone

(478) 472-0111

Fax

(478) 472-0112

NPI assigned

Apr 14, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Timothy Hall Jr., PHARMMD

Title

Owner

Phone

(478) 472-0111

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1003202342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506-C SPAULDING ROAD",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631804",
            "telephone_number": "478-472-0111",
            "fax_number": "478-472-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506-C SPAULDING ROAD",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631804",
            "telephone_number": "478-472-0111",
            "fax_number": "478-472-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLINT RIVER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-472-0111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARMMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE010139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Montezuma, GA
• Providers in Montezuma, GA by specialty
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.