Organization Active NPI

Southern Moodycare Inc

Doing business as Arlington Rexall Drugs

  • Long Term Care Pharmacy
  • Arlington, GA
National Provider Identifier
1154694487
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
SOUTHERN MOODYCARE INC
Doing business as
Arlington Rexall Drugs
Practice address
84 Maxwell St SE
Arlington, GA 39813-8712
Phone
(229) 725-4212
Fax
(229) 725-5242
NPI assigned
Feb 16, 2012
Last updated
Jul 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Authorized official

Name
Mr. Carson RayNPI 1447841028
Title
President/Pharmacist
Phone
(229) 725-4212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

84 Maxwell St SE
Arlington, GA 39813-8712

Mailing address

84 Maxwell St SE
Arlington, GA 39813-8712
Phone (229) 725-4212

Other identifiers 1

IdentifierTypeStateIssuer
PHRE004054OtherGASTATE LICENSE

Other names 1

  • Arlington Rexall Drugs Doing business as

National Provider Directory

National Provider Directory

Locations

84 Maxwell St SE
Arlington, GA 39813
Phone (229) 725-4212

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1154694487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 MAXWELL ST SE",
            "city": "ARLINGTON",
            "state": "GA",
            "postal_code": "398138712",
            "telephone_number": "229-725-4212",
            "fax_number": "229-725-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MAXWELL ST SE",
            "city": "ARLINGTON",
            "state": "GA",
            "postal_code": "398138712",
            "telephone_number": "229-725-4212",
            "fax_number": "229-725-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MOODYCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "CARSON",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "229-725-4212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PHRE004054",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arlington Rexall Drugs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arlington Rexall Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.