Jasper Drug Store at Foothills

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009465 Issued in GA

Legal business name

JASPER DRUG STORE AT FOOTHILLS

Doing business as

Jasper Drug Store at Foothills

Practice address

80 Foothills Pkwy
Marble Hill, GA 30148-2255

Phone

(770) 893-3784

Fax

(770) 893-3600

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Lee Dunn

Title

President

Phone

(706) 692-5910

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• JASPER DRUG STORE AT FOOTHILLS Doing business as

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.

• Haley Mullinax, PHARMD

  • Pharmacist
  • Jasper, GA
  • NPI 1023993573
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1104083450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 FOOTHILLS PKWY",
            "city": "MARBLE HILL",
            "state": "GA",
            "postal_code": "301482255",
            "telephone_number": "770-893-3784",
            "fax_number": "770-893-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 FOOTHILLS PKWY",
            "city": "MARBLE HILL",
            "state": "GA",
            "postal_code": "301482255",
            "telephone_number": "770-893-3784",
            "fax_number": "770-893-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER DRUG STORE AT FOOTHILLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-692-5910"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "998025657",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2017406",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JASPER DRUG STORE AT FOOTHILLS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joellen L Dreyfus, D.C.
• Foothills Chiropractic
• Foothills Dental, P.C. (Foothills Dental Associates)
• Foothills Management LLC (Foothills Chiropractic)
• Independent Physical Therapy of Ga, LLC (BenchMark Physical Therapy)
• Ravi Karan, D.C.
• Marie L. Loscavio, ED.D.
• Darrell Morton, DMD
• Barbara Peterson, MHA, MA, CCC-SLP
• Physical Medicine Centers of America LLC

• Community/Retail Pharmacy in Marble Hill, GA
• Providers in Marble Hill, 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 10, 2013; 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.