Gwinnett Supply Company LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

GWINNETT SUPPLY COMPANY LLC

Doing business as

Nephron Pharmacy

Practice address

605 Old Norcross Rd
Lawrenceville, GA 30046-4315

Phone

(678) 325-3331

Fax

(770) 339-1859

NPI assigned

Nov 27, 2018

Last updated

Feb 27, 2019By 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

Parmi Shah

Title

Administrator

Phone

(678) 469-9891

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nephron Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1053881623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464315",
            "telephone_number": "678-325-3331",
            "fax_number": "770-339-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464315",
            "telephone_number": "678-325-3331",
            "fax_number": "770-339-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT SUPPLY COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-27",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PARMI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-469-9891"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA BOARD OF PHARMACY",
            "identifier": "PHRE010690",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephron Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nephron Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gwinnett Psychology, LLC
• Gwinnett Pulmonary & Sleep, P.C.
• Gwinnett Pulmonary Group
• Gwinnett Smile Design
• Gwinnett Sportherapy
• Gwinnett Supply Company LLC
• Gwinnett Supply Company LLC (Nephron Dispensary)
• Gwinnett Surgery Center, LLC
• Gwinnett Surgical Associates, LLC
• Gwinnett Surgical Associates, LLP

• Pharmacy in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.