Individual provider Active NPI

Soumia Thakkolkaran

  • Pharmacist
  • Lawrenceville, GA
National Provider Identifier
1093097222
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH026259 Issued in GA
Practice address
2365 Buford Dr
Walgreens 6088
Lawrenceville, GA 30043-2609
Phone
(404) 543-8431
NPI assigned
Sep 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH026259 GA Primary

Addresses

Primary practice location

2365 Buford Dr
Walgreens 6088
Lawrenceville, GA 30043-2609

Mailing address

2365 Buford Dr
Walgreens 6088
Lawrenceville, GA 30043
Phone (404) 543-8431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RPH026259GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1093097222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 BUFORD DR",
            "address_2": "WALGREENS 6088",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30043",
            "telephone_number": "404-543-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 BUFORD DR",
            "address_2": "WALGREENS 6088",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432609",
            "telephone_number": "404-543-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKOLKARAN",
        "first_name": "SOUMIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH026259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.