Longs Drugs of Sandersville Georgia Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010092 Issued in GA

Legal business name

LONGS DRUGS OF SANDERSVILLE GEORGIA INC

Doing business as

Longs Dekalb Health Pharmacy

Practice address

1428 Scott Blvd
Decatur, GA 30030-1424

Phone

(404) 270-9242

Fax

(404) 270-9273

NPI assigned

May 4, 2010

Last updated

Dec 18, 2015By 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

Marshall Frost

Title

Director, Bus Dev/Owner

Phone

(404) 583-6945

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Longs Dekalb Health Pharmacy Doing business as

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1063730844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603111",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603111",
            "telephone_number": "803-254-5884",
            "fax_number": "866-717-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 SCOTT BLVD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301424",
            "telephone_number": "404-270-9242",
            "fax_number": "404-270-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUGS OF SANDERSVILLE GEORGIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "DIRECTOR, BUS DEV/OWNER",
        "authorized_official_telephone_number": "404-583-6945"
    },
    "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": "PHRE010092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149183",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Longs Dekalb Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tierra Long, OTR/L
• Long's Drugs of Sandersville Ga, Inc (Long's Dekalb Health Pharmacy)
• Long's Drugs of Sandersville, Georgia, Inc. (Long's Dekalb Health Pharmacy)
• Longevity Health Services LLC
• Cody Longfellow
• Verta Witherspoon Looper, LPC
• Aundrea Lopes, RRT
• Mary Lopez, MS, BCBA
• Laura Smith Lord, MD
• Sharlencia Lord

• Community/Retail Pharmacy in Decatur, GA
• Providers in Decatur, 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 Dec 18, 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.