Organization Active NPI

M D S Inc

  • Community/Retail Pharmacy
  • Dalton, GA
National Provider Identifier
1174610364
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE003475 Issued in GA
Legal business name
M D S INC
Practice address
1100 Burleyson Rd
Dalton, GA 30720-3016
Phone
(706) 278-2490
Fax
(706) 275-6157
NPI assigned
Oct 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Authorized official

Name
Hewlette Cook, RPH
Title
Pharmacist
Phone
(706) 278-2490

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE003475 GA Primary

Addresses

Primary practice location

1100 Burleyson Rd
Dalton, GA 30720-3016

Mailing address

1100 Burleyson Rd
Dalton, GA 30720-3016

Other identifiers 2

IdentifierTypeStateIssuer
1108770OtherNCPDP PROVIDER IDENTIFICATION NUMBER
00323419AMedicaidGA

Other names 1

  • PROFESSIONAL PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

1100 Burleyson Rd
Dalton, GA 30720
Phone (706) 278-2490

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745712000000",
    "number": "1174610364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BURLEYSON RD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203016",
            "telephone_number": "706-278-2490",
            "fax_number": "706-275-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M D S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "HEWLETTE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "706-278-2490",
        "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": "PHRE003475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1108770",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00323419A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2025; 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.