Organization Active NPI

Sutton Family Pharmacy Inc

  • Community/Retail Pharmacy
  • Dalton, GA
National Provider Identifier
1184804445
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009405 Issued in GA
Legal business name
SUTTON FAMILY PHARMACY INC
Practice address
3957 Cleveland Hwy
Unit a
Dalton, GA 30721-2052
Phone
(706) 852-1802
Fax
(706) 852-2206
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Gregory Sutton, RPH
Title
Owner
Phone
(706) 618-1773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009405 GA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

3957 Cleveland Hwy
Unit a
Dalton, GA 30721-2052

Mailing address

3957 Cleveland Hwy
Unit a
Dalton, GA 30721-2052
Phone (706) 852-1802

Other identifiers 2

IdentifierTypeStateIssuer
190764976AMedicaidGA
2016754OtherPK

Other names 1

  • SUTTON FAMILY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080805000050 GA Part B Supplier - Other 3577637834 Practice locations: Dalton, GA

National Provider Directory

National Provider Directory

Locations

3957 Cleveland Hwy
#A
Dalton, GA 30721
Phone (706) 618-1773

Practitioners & affiliated clinicians

Practitioners 2

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": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1184804445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3957 CLEVELAND HWY",
            "address_2": "UNIT A",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307212052",
            "telephone_number": "706-852-1802",
            "fax_number": "706-852-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3957 CLEVELAND HWY",
            "address_2": "UNIT A",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307212052",
            "telephone_number": "706-852-1802",
            "fax_number": "706-852-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTON FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-618-1773",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009405",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190764976A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016754",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUTTON FAMILY 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 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.