Active NPI
Edward Reizenson, RPH
- Pharmacist
- Buford, GA
National Provider Identifier
1144598707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH023024
- Practice address
- 2630 Braselton Hwy
Buford, GA 30519-5215 - Phone
- (678) 546-7328
- NPI assigned
- Dec 9, 2011
- Sex
- Male
- 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 | 043050 | NY | |
| Pharmacist | 183500000X | RPH023024 | GA | Primary |
Addresses
Primary practice location
2630 Braselton Hwy
Buford, GA 30519-5215
Mailing address
4035 Hillcrest View Court
Suwanee, GA 30024
Phone (770) 945-0962
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 |
|---|---|---|---|
| 043050 | NY | MD | General Practice Dentistry |
| RPH023024 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2630 Braselton Hwy
Buford, GA 30519
Phone (678) 546-7320
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": "1323388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1144598707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4035 HILLCREST VIEW COURT",
"city": "SUWANEE",
"state": "GA",
"postal_code": "30024",
"telephone_number": "770-945-0962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 BRASELTON HWY",
"city": "BUFORD",
"state": "GA",
"postal_code": "305195215",
"telephone_number": "678-546-7328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIZENSON",
"first_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-09",
"last_updated": "2023-01-31",
"certification_date": "2022-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "043050",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.