Active NPI
Adele Diane Dennard, RPH
- Pharmacist
- Soperton, GA
National Provider Identifier
1215078969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH016463
- Practice address
- 119 2ND St N
Soperton, GA 30457-1177 - Phone
- (912) 529-4545
- Fax
- (912) 529-6161
- NPI assigned
- Feb 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH016463 | GA | Primary |
Addresses
Primary practice location
119 2ND St N
Soperton, GA 30457-1177
Mailing address
1009 Florida Ave
Soperton, GA 30457-1722
Phone (912) 529-5252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH016463 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| L M Bass LLC | Pharmacist | Past | Accepting new patients |
| Dennards Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Soperton, GA
- NPI 1841362084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215078969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 FLORIDA AVE",
"city": "SOPERTON",
"state": "GA",
"postal_code": "304571722",
"telephone_number": "912-529-5252",
"fax_number": "912-529-6161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 2ND ST N",
"city": "SOPERTON",
"state": "GA",
"postal_code": "304571177",
"telephone_number": "912-529-4545",
"fax_number": "912-529-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNARD",
"first_name": "ADELE",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH016463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Soperton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.