First America Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHRE006796 Issued in GA

Legal business name

FIRST AMERICA PHARMACY INC

Practice address

3782 Old US Highway 41 N
Suite B
Valdosta, GA 31602-6834

Phone

(229) 253-0067

Fax

(229) 253-9010

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

William C. Allen Jr., RPHNPI 1689685398

Title

Owner

Phone

(229) 253-0067

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• AMERIMED PHARM AND EQUIPMENT 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.

• William Clyde Allen, R.PH.

  • Pharmacist
  • Hahira, GA
  • NPI 1689685398
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1124100912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3782 OLD US HIGHWAY 41 N",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026834",
            "telephone_number": "229-253-0067",
            "fax_number": "229-253-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3782 OLD US HIGHWAY 41 N",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026834",
            "telephone_number": "229-253-0067",
            "fax_number": "229-253-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST AMERICA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-253-0067",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE006796",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1110624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00768501A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMERIMED PHARM AND EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.