Edison Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE000311 Issued in GA

Legal business name

EDISON PHARMACY LLC

Doing business as

Lane Drug Co

Practice address

19427 Hartford St
Edison, GA 39846-5627

Phone

(229) 835-2212

Fax

(229) 835-2572

NPI assigned

Jan 8, 2007

Last updated

Oct 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward F Reynolds, RPH

Title

Owner MGR

Phone

(229) 835-2212

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LANE DRUG CO Doing business as

Practitioners 1

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.

• Jarrell Alan Ray, RPH

  • Pharmacist
  • Edison, GA
  • NPI 1225584022
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1164570099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "EDISON",
            "state": "GA",
            "postal_code": "398460248",
            "telephone_number": "229-835-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19427 HARTFORD ST",
            "city": "EDISON",
            "state": "GA",
            "postal_code": "398465627",
            "telephone_number": "229-835-2212",
            "fax_number": "229-835-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER MGR",
        "authorized_official_telephone_number": "229-835-2212",
        "authorized_official_credential": "RPH"
    },
    "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": "PHRE000311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000030533A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012347",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LANE DRUG CO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 464 Wellness Solutions LLC (Lane Medical LLC)
• Albany Area Primary Health Care, Inc. (Edison Medical Center)
• Calhoun County Special Education
• Shemika L Cox, LPN
• Melissa Hunt Dozier, FNP
• Abigail Jessica Glass, FNP-C
• Stephanie Theresa James, LMSW
• Jarrell Alan Ray, RPH
• Gashebal Nicole Robinson, NP
• Tracy Alissa Rosenbaum, DO

• Community/Retail Pharmacy in Edison, GA
• Providers in Edison, 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 Oct 27, 2015; 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.