Organization Active NPI

Rossville Worx LLC

Doing business as Longley's Pharmacy

  • Community/Retail Pharmacy
  • Rossville, GA
National Provider Identifier
1235668328
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ROSSVILLE WORX LLC
Doing business as
Longley's Pharmacy
Practice address
785 Chickamauga Ave
Rossville, GA 30741-1404
Phone
(706) 866-1220
NPI assigned
Jun 12, 2017
Last updated
May 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Mr. Greg Odell Bohannon
Title
President
Phone
(423) 309-1517

Specialties & licenses 2

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

Addresses

Primary practice location

785 Chickamauga Ave
Rossville, GA 30741-1404

Mailing address

785 Chickamauga Ave
Rossville, GA 30741-1404
Phone (706) 866-1220

Other identifiers 2

IdentifierTypeStateIssuer
003200177AMedicaidGA
Q032764MedicaidTN

Other names 1

  • LONGLEY'S PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180504000781 GA Part B Supplier - Pharmacy 2466716154 Practice locations: Rossville, GA
O20180831000254 GA DME Supplier - Pharmacy 2466716154 Practice locations: Rossville, GA

National Provider Directory

National Provider Directory
Tax ID family
Longley's Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1235668328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 CHICKAMAUGA AVE",
            "city": "ROSSVILLE",
            "state": "GA",
            "postal_code": "307411404",
            "telephone_number": "706-866-1220",
            "fax_number": "706-861-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 CHICKAMAUGA AVE",
            "city": "ROSSVILLE",
            "state": "GA",
            "postal_code": "307411404",
            "telephone_number": "706-866-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSSVILLE WORX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "BOHANNON",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "ODELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-309-1517",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003200177A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q032764",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LONGLEY'S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rossville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.