Quinate Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

QUINATE PHARMACY LLC

Doing business as

Southern Hometown Pharmacy

Practice address

546 W Bacon St
Pembroke, GA 31321-4648

Phone

(912) 653-1000

Fax

(912) 295-4667

NPI assigned

Aug 21, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Tracey Leavitt

Title

Managing Partner

Phone

(912) 509-3330

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern Hometown Pharmacy Doing business as

Tax ID family

Quinate Pharmacy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Quinate Pharmacy LLC

  • Community/Retail Pharmacy
  • Springfield, GA
  • NPI 1386205524
  NPD tax ID
• Quinate Pharmacy LLC

  • Community/Retail Pharmacy
  • Pooler, GA
  • NPI 1427518745
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Candace Lane Altman

  • Pharmacist
  • Pembroke, GA
  • NPI 1790311785
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1053891887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 POOLER PKWY STE 400",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224389",
            "telephone_number": "912-653-1000",
            "fax_number": "912-295-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 W BACON ST",
            "city": "PEMBROKE",
            "state": "GA",
            "postal_code": "313214648",
            "telephone_number": "912-653-1000",
            "fax_number": "912-295-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINATE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "912-509-3330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF PHARMACY",
            "identifier": "PHRE010656",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Jordan Lander, P. T.
• Aris Jade Lonon
• Malken Pharm Services Inc
• Janice Palmer, LPN
• Jennifer Creek Poston, PTA
• Janet Denise Rivers
• Saint Josephs Medical Group Inc
• Janice E. Shiver, NP
• Lisa Shuman, N.P.
• Teresa F Smith, RPH

• Community/Retail Pharmacy in Pembroke, GA
• Providers in Pembroke, 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 May 27, 2020; 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.