NPIMap

Organization Active NPI

Mount Vernon Drug Company

  • Pharmacist
  • Mount Vernon, GA
National Provider Identifier
1194868539
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
005037 Issued in GA
Legal business name
MOUNT VERNON DRUG COMPANY
Practice address
421 S Railroad Ave
Mount Vernon, GA 30445-0195
Phone
(912) 583-2216
Fax
(912) 583-2217
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Mr. Edward Darrell Sammons
Title
Owner Registered Pharmacist
Phone
(912) 583-2216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 005037 GA Primary

Addresses

Primary practice location

421 S Railroad Ave
Mount Vernon, GA 30445-0195

Mailing address

PO Box 195
421 S Railroad Avenue
Mount Vernon, GA 30445-0195
Phone (912) 583-2216

Other identifiers 1

IdentifierTypeStateIssuer
000032425AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1194868539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "address_2": "421 S RAILROAD AVENUE",
            "city": "MOUNT VERNON",
            "state": "GA",
            "postal_code": "304450195",
            "telephone_number": "912-583-2216",
            "fax_number": "912-583-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S RAILROAD AVE",
            "city": "MOUNT VERNON",
            "state": "GA",
            "postal_code": "304450195",
            "telephone_number": "912-583-2216",
            "fax_number": "912-583-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "SAMMONS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "DARRELL",
        "authorized_official_title_or_position": "OWNER REGISTERED PHARMACIST",
        "authorized_official_telephone_number": "912-583-2216",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "005037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000032425A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.