JM Cardinal Investments LLC North Fulton Hospital

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE007005 Issued in GA

Legal business name

JM CARDINAL INVESTMENTS LLC NORTH FULTON HOSPITAL

Doing business as

Concord Pharmacy

Practice address

2500 Hospital Blvd
Suite 300
Roswell, GA 30076

Phone

(770) 664-5429

Fax

(770) 664-4601

NPI assigned

Jul 27, 2006

Last updated

Apr 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Willie D Smith

Title

Owner

Phone

(678) 463-9598

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Concord Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Concord Inc

  dba Concord Pharmacy

  • Community/Retail Pharmacy
  • Suwanee, GA
  • NPI 1144244757

  3274946660

  Same PAC ID

Locations

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1255355855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 MAIN ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884829",
            "telephone_number": "678-285-0760",
            "fax_number": "770-971-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 300",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-664-5429",
            "fax_number": "770-664-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JM CARDINAL INVESTMENTS LLC NORTH FULTON HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-463-9598"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE007005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00322858E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concord Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andres Jimenez Acosta, DC
• Cassandra Lucia Jimenez
• JK Pulmonary and Sleep Medicine LLC
• JLM X-Ray LLC
• JM Cardinal Investments LLC North Fulton Hospital (Concord Drugs Roswell)
• Jmanor LLR (JManor Senior Living)
• John P Shallcross, Psy.D., P.C.
• Harry N John, M.D.
• Jace Anthony Johns-Cooper, MS, LPC
• Samerah Johns, LPN

• Community/Retail Pharmacy in Roswell, GA
• Providers in Roswell, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.