Organization Active NPI

Gayco Healthcare North LLC

  • Long Term Care Pharmacy
  • Alpharetta, GA
National Provider Identifier
1134564461
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHRE010193 Issued in GA
Legal business name
GAYCO HEALTHCARE NORTH LLC
Practice address
11800 Wills Rd
Suite 150
Alpharetta, GA 30009-2079
Phone
(770) 495-2950
Fax
(855) 568-9477
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Bent Gay, RPHNPI 1356343289
Title
Ceo
Phone
(478) 353-1579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PHRE010193 GA Primary

Addresses

Primary practice location

11800 Wills Rd
Suite 150
Alpharetta, GA 30009-2079

Mailing address

507 Industrial Blvd
Dublin, GA 31021-1714
Phone (770) 495-2950

Other identifiers 2

IdentifierTypeStateIssuer
003136467AMedicaidGA
2154669OtherPK

Other names 1

  • Gayco Healthcare - North Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210330000439 GA Part B Supplier - Pharmacy 8921413329 Practice locations: Alpharetta, GA
O20210423000717 GA Part B Supplier - Mass Immunization (Roster Biller Only) 8921413329 Practice locations: Alpharetta, GA

National Provider Directory

National Provider Directory

Locations

11800 Wills Rd
Ste 150
Alpharetta, GA 30009
Phone (770) 495-2950

507 Industrial Blvd
Dublin, GA 31021
Phone (478) 272-8093

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1134564461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 INDUSTRIAL BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310211714",
            "telephone_number": "770-495-2950",
            "fax_number": "855-568-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 WILLS RD",
            "address_2": "SUITE 150",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092079",
            "telephone_number": "770-495-2950",
            "fax_number": "855-568-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYCO HEALTHCARE NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "BENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-353-1579",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE010193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136467A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154669",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gayco Healthcare - North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.