RR Long Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE004185 Issued in GA

Legal business name

RR LONG INC

Doing business as

JACKSON DRUG CO

Practice address

4 2ND St
Jackson, GA 30233-1920

Phone

(770) 775-7880

Fax

(770) 775-1279

NPI assigned

Jun 15, 2006

Organization subpart

No

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

Authorized official

Name

Stanley Hogan, RPHNPI 1386083939

Title

Owner and President

Phone

(770) 775-7880

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• JACKSON DRUG CO Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stanley Lamar Hogan, BSRPH

  • Pharmacist
  • Jackson, GA
  • NPI 1386083939
  NPD (past) Authorized official

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1174567853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302330004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 2ND ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331920",
            "telephone_number": "770-775-7880",
            "fax_number": "770-775-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RR LONG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER AND PRESIDENT",
        "authorized_official_telephone_number": "770-775-7880",
        "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": "PHRE004185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110903",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00029807A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012451",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON DRUG CO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Lynn Ridall-Villagomez, MED
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• Suzette Robinson
• Neta J Roby, NPC
• Jessica Rosser, PHYSICAL THERAPY AST
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• Clyde William Sandford, LPC
• Sanjeeva Rao MD PC
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• Amir Shaheer

• Community/Retail Pharmacy in Jackson, GA
• Providers in Jackson, 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 Jul 1, 2013; 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.