Concord Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE008426 Issued in GA

Legal business name

CONCORD INC

Practice address

3890 Johns Creek Pkwy
Ste 160
Suwanee, GA 30024

Phone

(678) 417-0122

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Lisa A M Cord

Title

Corporate Secretary

Phone

(770) 671-0657

Specialties & licenses 1

Addresses

Other names 1

• Concord Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• JM Cardinal Investments LLC North Fulton Hospital

  • Community/Retail Pharmacy
  • Roswell, GA
  • NPI 1255355855

  3274946660

  Same PAC ID

Locations

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144244757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8046 ROSWELL RD",
            "address_2": "STE 202",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30350",
            "telephone_number": "770-671-0657",
            "fax_number": "770-393-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 JOHNS CREEK PKWY",
            "address_2": "STE 160",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "678-417-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "M CORD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "770-671-0657"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE008426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elizabeth Margaret Cooke, MS LPC NCC

• Community/Retail Pharmacy in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.