Organization Active NPI

Armuchee Pharmacy, LLC

  • Community/Retail Pharmacy
  • Rome, GA
National Provider Identifier
1013072693
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ARMUCHEE PHARMACY, LLC
Practice address
4334 Martha Berry Hwy NE
Rome, GA 30165-8642
Phone
(706) 235-1303
Fax
(706) 235-8239
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
Austin RatliffNPI 1952032500
Title
Owner
Phone
(706) 235-1303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4334 Martha Berry Hwy NE
Rome, GA 30165-8642

Mailing address

4334 Martha Berry Hwy NE
Rome, GA 30165-8642
Phone (706) 235-1303

Other identifiers 2

IdentifierTypeStateIssuer
00611861AMedicaidGA
2018934OtherPK

Other names 1

  • ARMUCHEE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201210000825 GA Part B Supplier - Mass Immunization (Roster Biller Only) 6305258617 Practice locations: Rome, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2212194Armuchee Pharmacy, LLC4334 Martha Berry Highway NE, Rome, GA 30165Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

Locations

4334 Martha Berry Hwy NE
Rome, GA 30165
Phone (706) 235-1303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1013072693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 MARTHA BERRY HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301658642",
            "telephone_number": "706-235-1303",
            "fax_number": "706-235-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 MARTHA BERRY HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301658642",
            "telephone_number": "706-235-1303",
            "fax_number": "706-235-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARMUCHEE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "RATLIFF",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-235-1303"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00611861A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2018934",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARMUCHEE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.