Active NPI
Beasley Drug Company
- Community/Retail Pharmacy
- Conyers, GA
National Provider Identifier
1013041722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHRE009906
- Legal business name
- BEASLEY DRUG COMPANY
- Practice address
- 933 Center St NE
Conyers, GA 30012-4567 - Phone
- (770) 483-7211
- Fax
- (770) 483-9654
- NPI assigned
- Mar 15, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Waleed Khatri
- Title
- President
- Phone
- (347) 819-5282
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PHRE009906 | GA | Primary |
Addresses
Primary practice location
933 Center St NE
Conyers, GA 30012-4567
Mailing address
933 Center St NE
Conyers, GA 30012-4567
Phone (770) 483-7211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2139785 | Other | PK |
Other names 1
- Beasley Drug Company
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130509000307 | GA | DME Supplier - Pharmacy | 3173760287 | Practice locations: Conyers, GA |
| O20211119000573 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 3173760287 | Practice locations: Conyers, GA |
National Provider Directory
National Provider Directory- Tax ID family
- Beasley Drug Company
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Conyers, GA
- NPI 1104161710
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Conyers, GA
- NPI 1598355869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762819200000",
"number": "1013041722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 CENTER ST NE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300124567",
"telephone_number": "770-483-7211",
"fax_number": "770-483-9654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 CENTER ST NE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300124567",
"telephone_number": "770-483-7211",
"fax_number": "770-483-9654"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEASLEY DRUG COMPANY",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-15",
"last_updated": "2025-11-11",
"certification_date": "2025-11-11",
"status": "A",
"authorized_official_last_name": "KHATRI",
"authorized_official_first_name": "WALEED",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "347-819-5282"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "GA",
"license": "PHRE009906",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2139785",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Beasley Drug Company",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.