Hiram Douglas Keith Coffey Jr., RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

13963 Issued in GA

Practice address

430 N 3Rd Ave
Chatsworth, GA 30705-2540

Phone

(706) 695-0444

NPI assigned

Jun 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1134780976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 STAFFORD RD",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307055760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N 3RD AVE",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052540",
            "telephone_number": "706-695-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 Stafford Rd",
            "address_purpose": "LOCATION",
            "city": "Chatsworth",
            "state": "GA",
            "postal_code": "307055760",
            "country_code": "US",
            "telephone_number": "706-695-8216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "HIRAM",
        "middle_name": "DOUGLAS KEITH",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "13963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Chatsworth, GA
• Providers in Chatsworth, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.