Active NPI
Clinic Drug Store, Inc.
Doing business as Plains Pharmacy
- Long Term Care Pharmacy
- Plains, GA
National Provider Identifier
1144749847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- CLINIC DRUG STORE, INC.
- Doing business as
- Plains Pharmacy
- Practice address
- 103 Main St
Plains, GA 31780 - Phone
- (229) 824-5255
- Fax
- (229) 824-3703
- NPI assigned
- Sep 13, 2017
- Last updated
- Jul 21, 2022
- Organization subpart
- Yes
- Parent organization
- CLINIC DRUG STORE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lee Pinnell, PHARM.D.
- Title
- Owner
- Phone
- (229) 824-5255
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | NU | Primary |
Addresses
Primary practice location
103 Main St
Plains, GA 31780
Mailing address
103 Main St
Plains, GA 31780
Phone (229) 824-5255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000033393A | Medicaid | GA |
Other names 1
- Plains Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Clinic Drug Store
- Part of
- Clinic Drug Store
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1144749847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 MAIN ST",
"city": "PLAINS",
"state": "GA",
"postal_code": "31780",
"telephone_number": "229-824-5255",
"fax_number": "229-824-3703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 MAIN ST",
"city": "PLAINS",
"state": "GA",
"postal_code": "31780",
"telephone_number": "229-824-5255",
"fax_number": "229-824-3703"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINIC DRUG STORE, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CLINIC DRUG STORE, INC.",
"enumeration_date": "2017-09-13",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "PINNELL",
"authorized_official_first_name": "LEE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "229-824-5255",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM.D."
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000033393A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Plains Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Plains, GA
- Latonya Quanta Blackmon
- Sarah Cantrell, FNP-BC
- Clinic Drug Store (Plains Pharmacy)
- Jennifer Lynn Fedderick, MS
- Patricia Barrett Fennessy, MD
- Lillian Carter Health Center LLC
- Lillian G. Carter Nursing Center LLC (Lillian G. Carter Nursing Center)
- Lillian G. Carter Nursing Center LLC (Lillian G. Carter Health and Rehabilitation)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.