Organization Active NPI

Yetola Inc

  • Long Term Care Pharmacy
  • Marietta, GA
National Provider Identifier
1043221682
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
YETOLA INC
Doing business as
PEACHVIEW DRUGS
Practice address
525 Franklin Gtwy SE
Marietta, GA 30067-7707
Phone
(678) 581-1223
Fax
(678) 581-2356
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Yetunde Ezeanii
Title
Ceo
Phone
(678) 581-1223

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X PHRE008552 GA
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

525 Franklin Gtwy SE
Marietta, GA 30067-7707

Mailing address

525 Franklin Gtwy SE
Marietta, GA 30067-7707
Phone (678) 581-1223

Other identifiers 2

IdentifierTypeStateIssuer
2014409OtherPK
00925097AMedicaidGA

Other names 1

  • PEACHVIEW DRUGS Doing business as

National Provider Directory

National Provider Directory

Locations

525 Franklin Gtwy SE
Marietta, GA 30067
Phone (678) 581-1223

Practitioners & affiliated clinicians

Practitioners 3

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1043221682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 FRANKLIN GTWY SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677707",
            "telephone_number": "678-581-1223",
            "fax_number": "678-581-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 FRANKLIN GTWY SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677707",
            "telephone_number": "678-581-1223",
            "fax_number": "678-581-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YETOLA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "EZEANII",
        "authorized_official_first_name": "YETUNDE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-581-1223"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "GA",
            "license": "PHRE008552",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014409",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00925097A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEACHVIEW DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEACHVIEW DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.