Old Norcross Road Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009621 Issued in GA

Legal business name

OLD NORCROSS ROAD PHARMACY LLC

Doing business as

Old Norcross Road Pharmacy

Practice address

558 Old Norcross Rd
Suite 201
Lawrenceville, GA 30046-4385

Phone

(770) 682-8622

Fax

(770) 682-8623

NPI assigned

Dec 8, 2009

Organization subpart

No

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

Authorized official

Name

Linus Igbokwe

Title

Director/ Owner

Phone

(770) 682-8622

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Old Norcross Road Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1174852966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 OLD NORCROSS RD",
            "address_2": "SUITE 201",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464385",
            "telephone_number": "770-682-8622",
            "fax_number": "770-682-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 OLD NORCROSS RD",
            "address_2": "SUITE 201",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464385",
            "telephone_number": "770-682-8622",
            "fax_number": "770-682-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD NORCROSS ROAD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "IGBOKWE",
        "authorized_official_first_name": "LINUS",
        "authorized_official_title_or_position": "DIRECTOR/ OWNER",
        "authorized_official_telephone_number": "770-682-8622"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1159424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Norcross Road Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• May C Okoye, PHARMD
• Toyin Okunato, RN
• Oladoyin Olaiya Oni
• Olan Comprehensive Healthcare
• Chikodi S. Olayinka
• Hayley Savanna Oliver, LPMT, MT-BC
• Jelessa Oliver, RN
• Mackenzie Brown Oliver
• Sarah Oliver
• Jacob Alan Oliverson

• Community/Retail Pharmacy in Lawrenceville, GA
• Providers in Lawrenceville, 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 Aug 10, 2010; 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.