Rocky Top Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE007220 Issued in GA

Legal business name

ROCKY TOP PHARMACY INC

Doing business as

Longley Pharmacy

Practice address

785 Chickamauga Ave
Rossville, GA 30741-1404

Phone

(706) 866-1220

Fax

(706) 861-7505

NPI assigned

Nov 17, 2006

Last updated

Apr 20, 2016By 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

Jerry Grimmitt, RPHNPI 1871668020

Title

President

Phone

(706) 866-1220

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LONGLEY PHARMACY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry Vance Grimmitt, RPH

  • Pharmacist
  • Rossville, GA
  • NPI 1871668020
  Authorized official Same address or phone

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1073687596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 CHICKAMAUGA AVE",
            "city": "ROSSVILLE",
            "state": "GA",
            "postal_code": "307411404",
            "telephone_number": "706-866-1220",
            "fax_number": "706-861-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 CHICKAMAUGA AVE",
            "city": "ROSSVILLE",
            "state": "GA",
            "postal_code": "307411404",
            "telephone_number": "706-866-1220",
            "fax_number": "706-861-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY TOP PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "GRIMMITT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-866-1220",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE007220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012939",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00438017A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LONGLEY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Primary Health Care Center of Dade, Inc. (Primary Health Care at Rossville Elementary SBHC)
• Primary Health Care Center of Dade, Inc. (Primary Health Care Rossville Middle School SBHC)
• Quality Living AIDS
• Sybil Rochelle Reddick, MD
• Reset Counseling and Wellness, LLC
• Rossville Worx LLC (Longley's Pharmacy)
• Rossville Worx LLC
• John Savaiinaea
• Patrick Scheel
• Beatriz Eneida Seales-Tealdi, LCSW

• Community/Retail Pharmacy in Rossville, GA
• Providers in Rossville, 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 Apr 20, 2016; 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.