Organization Active NPI

Piedmont Direct Pharmacy LLC

  • Community/Retail Pharmacy
  • Bogart, GA
National Provider Identifier
1134712763
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PIEDMONT DIRECT PHARMACY LLC
Practice address
190 Ben Burton Cir
Bogart, GA 30622-1790
Phone
(833) 551-2024
Fax
(833) 439-0010
NPI assigned
Feb 15, 2021
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Jennifer Storey HarbinNPI 1780744243
Title
Executive Director
Phone
(706) 660-2877

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

190 Ben Burton Cir
Bogart, GA 30622-1790

Mailing address

190 Ben Burton Cir
Bogart, GA 30622-1790
Phone (833) 551-2024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211006001738 GA Part B Supplier - Pharmacy 6608274667 Practice locations: Bogart, GA

National Provider Directory

National Provider Directory

Locations

1510 Prince Ave
Ste A
Athens, GA 30606
Phone (833) 551-2024

190 Ben Burton Cir
Bogart, GA 30622
Phone (833) 551-2024

Practitioners & affiliated clinicians

Practitioners 2

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": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1134712763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 BEN BURTON CIR",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306221790",
            "telephone_number": "833-551-2024",
            "fax_number": "833-439-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 BEN BURTON CIR",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306221790",
            "telephone_number": "833-551-2024",
            "fax_number": "833-439-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT DIRECT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "HARBIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "STOREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "706-660-2877"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogart, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.