NPIMap

Organization Active NPI

Dermatran Health Solutions LLC

Doing business as DermaTran Health Solutions

  • Community/Retail Pharmacy
  • Rome, GA
National Provider Identifier
1174898464
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009821 Issued in GA
Legal business name
DERMATRAN HEALTH SOLUTIONS LLC
Doing business as
DermaTran Health Solutions
Practice address
85 Technology Pkwy NW
Rome, GA 30165-1382
Phone
(706) 844-1502
Fax
(844) 265-1995
NPI assigned
Mar 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Tony Rayfus
Title
Director/Owner
Phone
(855) 675-5200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009821 GA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

85 Technology Pkwy NW
Rome, GA 30165-1382

Mailing address

PO Box 108
Rome, GA 30162-0108
Phone (855) 675-5200

Other identifiers 1

IdentifierTypeStateIssuer
2134297OtherPK

Other names 1

  • DermaTran Health Solutions Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dermatran Health Solutions4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

85 Technology Pkwy NW
Rome, GA 30165
Phone (855) 675-5202

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": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1174898464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620108",
            "telephone_number": "855-675-5200",
            "fax_number": "844-265-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651382",
            "telephone_number": "706-844-1502",
            "fax_number": "844-265-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATRAN HEALTH SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "RAYFUS",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "855-675-5200"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009821",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DermaTran Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DermaTran Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.