Kennison Pharmacy, LLC
Organization Active NPI Community/Retail Pharmacy · Buford, GA
NPI 1013471010 · NPPES record last updated Mar 19, 2026
Key facts
- NPI
- 1013471010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- KENNISON PHARMACY, LLC
- Practice address
- 4050 Buford Drive
Buford, GA 30518 - Phone
- (678) 288-9798
- Fax
- (678) 288-9839
- NPI assigned
- Jan 24, 2019
- Organization subpart
- No
Authorized official
- Name
- Kenneth Amankwah Kwarteng
- Title
- Owner/Pharmacist in Charge
- Phone
- (404) 789-0048
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211112002206 | GA | Part B Supplier - Pharmacy | 2062830896 | Practice locations: Buford, GA |
| O20211112002422 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 2062830896 | Practice locations: Buford, GA |
National Provider Directory
- Tax ID family
- Kennison Pharmacy LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes | ||
| Compounding Pharmacy | 3336C0004X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
4050 Buford Drive
Buford, GA 30518
Mailing address
1600 Pinehurst View Drive
Grayson, GA 30017
Phone (404) 789-0048
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003218175A | Medicaid | GA |
Other names
- Complete Care Pharmacy
Other providers in Buford, GA
- Naser Kargar
- Neyazia Karim
- Erica M Kasler
- Kathleen J McGregor, M.a.
- Roghieh Beigom Kazeroonian
- Kennison Pharmacy, LLC
- Sybil Marcella Kent
- Zainab Kausar Khan
- Alhana Khobeir
- Mohsen Khodakaram
All providers in Buford, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.