Bennetts Hometown Pharmacy- Blackshear LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BENNETTS HOMETOWN PHARMACY- BLACKSHEAR LLC

Doing business as

Pierce Family Pharmacy

Practice address

3150 US Highway 84
Blackshear, GA 31516-4944

Phone

(912) 449-1400

NPI assigned

Oct 11, 2018

Last updated

Oct 11, 2018By 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

Ms. Denise Bennett

Title

Owner,Pharmacist

Phone

(912) 286-3784

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Pierce Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 3

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.

• Brie Edgerton Long, PHARM.D.

  • Pharmacist
  • Nahunta, GA
  • NPI 1295453579
  NPD (past)
• Ashton Quick

  • Pharmacist
  • Nahunta, GA
  • NPI 1821689621
  NPD (past)
• Tiffany Amber Woods, PHARMD

  • Pharmacist
  • Blackshear, GA
  • NPI 1174114953
  NPD (past)

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1093280539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315160864",
            "telephone_number": "912-286-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 US HIGHWAY 84",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164944",
            "telephone_number": "912-449-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETTS HOMETOWN PHARMACY- BLACKSHEAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OWNER,PHARMACIST",
        "authorized_official_telephone_number": "912-286-3784",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391060474A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pierce Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bennett Mobility Products LLC
• Grant Douglas Bennett
• Heidi Rose Bennett, MS
• Shannon Strickland Bennett, CCC-SLP
• Stetson Fleming Bennett III
• Big Umbrella Counseling
• Blackshear Dental Care, LLC
• Blackshear Drug Co
• Blackshear Family Dentistry LLC
• Bloom Well Health Clinic LLC

• Community/Retail Pharmacy in Blackshear, GA
• Providers in Blackshear, 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 Oct 11, 2018; 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.