Organization Active NPI

Woodstock Pharmaceutical & Compounding Center Inc

Doing business as Woodstock Pharmacy

  • Long Term Care Pharmacy
  • Woodstock, GA
National Provider Identifier
1184128290
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHRE007695 Issued in GA
Legal business name
WOODSTOCK PHARMACEUTICAL & COMPOUNDING CENTER INC
Doing business as
Woodstock Pharmacy
Practice address
8612 Main St
Woodstock, GA 30188-4829
Phone
(678) 285-0760
Fax
(770) 971-0315
NPI assigned
Mar 22, 2018
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Jonathan Marquess
Title
Pharmacy Owner
Phone
(770) 092-6647

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X PHRE007695 GA Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

8612 Main St
Woodstock, GA 30188-4829

Mailing address

8612 Main St
Woodstock, GA 30188-4829
Phone (678) 285-0760

Other identifiers 2

IdentifierTypeStateIssuer
2176507OtherPK
000178373AMedicaidGA

Other names 1

  • WOODSTOCK PHARMACY Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0977638Woodstock Pharmacy and Compounding Ctr8612 Main Street, Woodstock, GA 30188Certificate of waiverAug 30, 2026

National Provider Directory

National Provider Directory

Locations

8612 Main St
Woodstock, GA 30188
Phone (312) 806-3800

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1184128290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 MAIN ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884829",
            "telephone_number": "678-285-0760",
            "fax_number": "770-971-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8612 MAIN ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884829",
            "telephone_number": "678-285-0760",
            "fax_number": "770-971-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK PHARMACEUTICAL & COMPOUNDING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "MARQUESS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PHARMACY OWNER",
        "authorized_official_telephone_number": "770-092-6647"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE007695",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176507",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000178373A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOODSTOCK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.