Peachtree Pharmacy Services

Primary specialty

PharmacistTaxonomy code 183500000X

License

014565 Issued in GA

Legal business name

PEACHTREE PHARMACY SERVICES

Practice address

1018 South Main STR
Hwy 129 Suite a
Cleveland, GA 30528

Phone

(706) 865-0367

Fax

(706) 865-0931

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. James Charles Herndon, RPH

Title

Pharmacy Manager

Phone

(706) 865-0367

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1023210044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 SOUTH MAIN STR",
            "address_2": "HWY 129 SUITE A",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "30528",
            "telephone_number": "706-865-0367",
            "fax_number": "706-865-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 SOUTH MAIN STR",
            "address_2": "HWY 129 SUITE A",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "30528",
            "telephone_number": "706-865-0367",
            "fax_number": "706-865-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PHARMACY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "HERNDON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "706-865-0367",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "014565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LIC NUM",
            "identifier": "PHRE009156",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northeast Georgia Physicians Group-Urgent Care, LLC
• O.W.a. Management Services, LLC (Cleveland Family Dental Center)
• Emily O'Bryant, PTA
• Meredith Palmer
• Carol Vandiver Patterson
• Peachtree Pharmacy Services, L.L.C.
• Petitt Chiropractic Clinic; P.C.
• James Gregory Petitt, DC
• Janette Virginia Piedra, PT, DPT
• Anna H Powell, MD

• Pharmacist in Cleveland, GA
• Providers in Cleveland, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.