NPIMap

Organization Active NPI

Southern Family Markets LLC

  • Community/Retail Pharmacy
  • Carrollton, GA
National Provider Identifier
1245323609
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE008612 Issued in GA
Legal business name
SOUTHERN FAMILY MARKETS LLC
Practice address
505 Bankhead Hwy
Carrollton, GA 30117-2446
Phone
(678) 796-0605
Fax
(678) 796-0624
NPI assigned
Sep 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Authorized official

Name
Mark Tow
Title
Director of Pharmacy
Phone
(205) 912-4234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE008612 GA Primary

Addresses

Primary practice location

505 Bankhead Hwy
Carrollton, GA 30117-2446

Mailing address

PO Box 8500
Lockbox 8531
Philadelphia, PA 19178-8531

Other identifiers 2

IdentifierTypeStateIssuer
950825064AMedicaidGA
1153460OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • SOUTHERN FAMILY MARKET Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Family Market27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

505 Bankhead Hwy
Carrollton, GA 30117
Phone (678) 796-0605

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1245323609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX 8531",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BANKHEAD HWY",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172446",
            "telephone_number": "678-796-0605",
            "fax_number": "678-796-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FAMILY MARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "TOW",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "205-912-4234"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE008612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950825064A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1153460",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN FAMILY MARKET",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.