Organization Active NPI

W & W Smith Pharmacies Inc

  • Community/Retail Pharmacy
  • Dublin, GA
National Provider Identifier
1154428993
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE006120 Issued in GA
Legal business name
W & W SMITH PHARMACIES INC
Practice address
2406 Bellevue Rd
Dublin, GA 31021
Phone
(478) 272-8065
Fax
(478) 272-8065
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Authorized official

Name
Wendell Smith
Title
President
Phone
(478) 272-8065

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE006120 GA Primary

Addresses

Primary practice location

2406 Bellevue Rd
Dublin, GA 31021

Mailing address

2406 Bellevue Rd
Dublin, GA 31021

Other identifiers 2

IdentifierTypeStateIssuer
00521045AMedicaidGA
1123962OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MEDICAL PARK PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240503000156 GA Part B Supplier - Pharmacy 3577683739 Practice locations: Dublin, GA

National Provider Directory

National Provider Directory

Locations

2406 Bellevue Rd
Dublin, GA 31021
Phone (478) 275-0580

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1154428993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "31021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "31021",
            "telephone_number": "478-272-8065",
            "fax_number": "478-272-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W & W SMITH PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-272-8065"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE006120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00521045A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1123962",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.