NPIMap

Organization Active NPI

Cathey Valley Pharmacy, Inc

  • Pharmacy
  • Dillard, GA
National Provider Identifier
1215913033
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHRE003315 Issued in GA
Legal business name
CATHEY VALLEY PHARMACY, INC
Practice address
6712 Highway 441 N
Dillard, GA 30537-2203
Phone
(706) 746-5335
Fax
(800) 347-9865
NPI assigned
Dec 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Patricia Long
Title
V.P.
Phone
(386) 698-3737

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X GA381 KY
Pharmacy 333600000X PHRE003315 GA Primary

Addresses

Primary practice location

6712 Highway 441 N
Dillard, GA 30537-2203

Mailing address

6712 Highway 441 N
Dillard, GA 30537-2203
Phone (706) 746-5335

Other identifiers 5

IdentifierTypeStateIssuer
DE1064MedicaidSC
00037716AMedicaidGA
0217321000MedicaidWV
7702080MedicaidNC
00037716BMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215913033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 HIGHWAY 441 N",
            "city": "DILLARD",
            "state": "GA",
            "postal_code": "305372203",
            "telephone_number": "706-746-5335",
            "fax_number": "800-347-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712 HIGHWAY 441 N",
            "city": "DILLARD",
            "state": "GA",
            "postal_code": "305372203",
            "telephone_number": "706-746-5335",
            "fax_number": "800-347-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHEY VALLEY PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "386-698-3737",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "GA381",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE003315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1064",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00037716A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217321000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7702080",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00037716B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillard, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.