Organization Active NPI

Fords Pharmacy LLC

Doing business as Ford's Pharmacy

  • Community/Retail Pharmacy
  • Adairsville, GA
National Provider Identifier
1104132521
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009680 Issued in GA
Legal business name
FORDS PHARMACY LLC
Doing business as
Ford's Pharmacy
Practice address
7441 Adairsville Hwy
Adairsville, GA 30103-2014
Phone
(770) 773-1800
Fax
(770) 773-1809
NPI assigned
Aug 23, 2010
Last updated
Dec 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Authorized official

Name
Mark Ford
Title
Owner
Phone
(770) 547-1465

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU
Community/Retail Pharmacy 3336C0003X PHRE009680 GA Primary

Addresses

Primary practice location

7441 Adairsville Hwy
Adairsville, GA 30103-2014

Mailing address

7441 Adairsville Hwy
Adairsville, GA 30103-2014
Phone (770) 773-1800

Other identifiers 1

IdentifierTypeStateIssuer
2126305OtherPK

Other names 1

  • Ford's Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210125001025 GA Part B Supplier - Pharmacy 0941614440 Practice locations: Adairsville, GA
O20210913002450 GA Part B Supplier - Independent Clinical Laboratory 0941614440 Practice locations: Adairsville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2214069Fords Pharmacy7441 Adairsville Highway, Adairsville, GA 30103Certificate of waiverFeb 17, 2027

National Provider Directory

National Provider Directory

Locations

7441 Adairsville Hwy
Adairsville, GA 30103
Phone (770) 773-1800

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609372800000",
    "number": "1104132521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7441 ADAIRSVILLE HWY",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032014",
            "telephone_number": "770-773-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7441 ADAIRSVILLE HWY",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032014",
            "telephone_number": "770-773-1800",
            "fax_number": "770-773-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORDS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-547-1465"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ford's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ford's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Adairsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.