NPIMap

Organization Active NPI

Long'S Drugs of Sandersville Ga, Inc

  • Community/Retail Pharmacy
  • Decatur, GA
National Provider Identifier
1023334570
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE010092 Issued in GA
Legal business name
LONG'S DRUGS OF SANDERSVILLE GA, INC
Doing business as
Long's Dekalb Health Pharmacy
Practice address
1524 Church St
Suite D
Decatur, GA 30030-6500
Phone
(404) 270-9242
Fax
(404) 270-9273
NPI assigned
Apr 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Marshall Frost, PHARMD
Title
Director
Phone
(404) 583-6945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE010092 GA Primary

Addresses

Primary practice location

1524 Church St
Suite D
Decatur, GA 30030-6500

Mailing address

1524 Church St
Suite D
Decatur, GA 30030-6500
Phone (404) 270-9242

Other identifiers 2

IdentifierTypeStateIssuer
PHRE010092OtherGABOARD OF PHARMACY PERMIT
102598233AMedicaidGA

Other names 1

  • Long's Dekalb Health Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Long'S Drugs of Sandersville Georgia Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1524 Church St
Ste D
Decatur, GA 30030
Phone (404) 270-9242

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1023334570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 CHURCH ST",
            "address_2": "SUITE D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300306500",
            "telephone_number": "404-270-9242",
            "fax_number": "404-270-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 CHURCH ST",
            "address_2": "SUITE D",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300306500",
            "telephone_number": "404-270-9242",
            "fax_number": "404-270-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG'S DRUGS OF SANDERSVILLE GA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-583-6945",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "PHRE010092",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102598233A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long's Dekalb Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.