Northside Pharmacy, Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

006380 Issued in GA

Legal business name

NORTHSIDE PHARMACY, INC.

Practice address

440 Charter Blvd
Suite 1107
Macon, GA 31210-4857

Phone

(478) 474-6767

NPI assigned

Jan 25, 2007

Last updated

Aug 22, 2020By 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

Ricki A Oliver

Title

Owner

Phone

(478) 474-6767

Specialties & licenses 1

Addresses

Locations

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.

• David Baugh Graves, R.PH

  • Pharmacist
  • Macon, GA
  • NPI 1952523367
  NPD

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093860280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 CHARTER BLVD",
            "address_2": "SUITE 1107",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104857",
            "telephone_number": "478-474-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 CHARTER BLVD",
            "address_2": "SUITE 1107",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104857",
            "telephone_number": "478-474-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "RICKI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-474-6767"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "006380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Macon Family Physicians, LLC
• Northeast Chiropractic Clinic
• Northside Family Dentistry
• Northside Hospital, Inc. (The Pharmacy Center)
• Northside Pediatrics PC
• Northwest Diagnostic Imaging, Inc (Open MRI & Imaging of Macon, LLC)
• Patrick Richard Notini, MD
• Michelle Leigh Nowell, FNP
• Nra Macon Georgia LLC (Eisenhower Parkway Dialysis Center)
• Nra Midtown Macon Georgia LLC (Midtown Macon Dialysis Center)

• Pharmacist in Macon, GA
• Providers in Macon, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.