Holly Springs Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009819 Issued in GA

Legal business name

HOLLY SPRINGS PHARMACY LLC

Doing business as

PharMoore Pharmacy

Practice address

3422 Sixes Rd Ste 106
Canton, GA 30114-9120

Phone

(770) 213-3341

Fax

(770) 213-3294

NPI assigned

Mar 4, 2012

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Marquess, RPH

Title

Owner/RPH/Ao

Phone

(678) 285-0760

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PharMoore Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1330819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1023382314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 SIXES RD STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149120",
            "telephone_number": "770-213-3341",
            "fax_number": "770-213-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3422 SIXES RD STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149120",
            "telephone_number": "770-213-3341",
            "fax_number": "770-213-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY SPRINGS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-04",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "MARQUESS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/RPH/AO",
        "authorized_official_telephone_number": "678-285-0760",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135011A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2170893",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMoore Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holcomb's Foot & Leg Clinic of Cumming (Cumming Foot & Leg Clinic)
• Maria Jane Holder, NP
• Diane L Hollander, PSYD, BCBA-D
• Sandra Sue Hollingsworth, R.PH.
• Holly Springs Chiropractic Clinic, Inc. (Optimal Health Center of Canton)
• Holly Springs Pharmacy LLC (Pharmoore Pharmacy)
• Nicole Teresa Hood, FNP
• Kori Alise Hooks
• Hope Kidney Clinic LLC
• Nicholas Tycho Hornbuckle, PHARMD

• Community/Retail Pharmacy in Canton, GA
• Providers in Canton, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.

Verify at the official NPI Registry.