Active NPI
Deborah Morris Hazen
- Pharmacist
- Canton, GA
National Provider Identifier
1225376445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12032
- Practice address
- 1451 Riverstone Pkwy
Canton, GA 30114-5624 - Phone
- (770) 720-1042
- NPI assigned
- Jan 23, 2013
- Last updated
- Jan 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 12032 | GA | Primary |
Addresses
Primary practice location
1451 Riverstone Pkwy
Canton, GA 30114-5624
Mailing address
1105 Woodridge Way
Canton, GA 30114-8921
Phone (770) 356-7450
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12032 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets 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.
-
dba Publix Pharmacy #0624
- Community/Retail Pharmacy
- Canton, GA
- NPI 1295776789
-
dba Publix Pharmacy #2107
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358899200000",
"number": "1225376445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 WOODRIDGE WAY",
"city": "CANTON",
"state": "GA",
"postal_code": "301148921",
"telephone_number": "770-356-7450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1451 RIVERSTONE PKWY",
"city": "CANTON",
"state": "GA",
"postal_code": "301145624",
"telephone_number": "770-720-1042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEN",
"first_name": "DEBORAH",
"middle_name": "MORRIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-23",
"last_updated": "2013-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "12032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.