Active NPI
Edie Antoinette Swaggard-Green, R.PH
- Pharmacist
- Villa Rica, GA
National Provider Identifier
1124305602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH025125
- Practice address
- 684 W Bankhead Hwy
Villa Rica, GA 30180-1601 - Phone
- (770) 459-9344
- NPI assigned
- Nov 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH025125 | GA | Primary |
| Pharmacist | 183500000X | 045228 | NY |
Addresses
Primary practice location
684 W Bankhead Hwy
Villa Rica, GA 30180-1601
Mailing address
9980 Devonshire St
Douglasville, GA 30135-8184
Phone (716) 308-6266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH025125 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320883200000",
"number": "1124305602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9980 DEVONSHIRE ST",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301358184",
"telephone_number": "716-308-6266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "684 W BANKHEAD HWY",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301801601",
"telephone_number": "770-459-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAGGARD-GREEN",
"first_name": "EDIE",
"middle_name": "ANTOINETTE",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-10",
"last_updated": "2011-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH025125",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045228",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Rica, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.