Crisp & Associates II, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHHH000063 Issued in GA

Legal business name

CRISP & ASSOCIATES II, LLC

Practice address

4980 Phillips Dr
Forest Park, GA 30297-1472

Phone

(404) 362-2990

Fax

(404) 362-2994

NPI assigned

Jun 8, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Ray Wayne Crisp, RPH

Title

Owner

Phone

(404) 362-2990

Specialties & licenses 4

Addresses

Other names 1

• Christians Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1255780441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 PHILLIPS DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971472",
            "telephone_number": "404-362-2990",
            "fax_number": "404-362-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 PHILLIPS DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971472",
            "telephone_number": "404-362-2990",
            "fax_number": "404-362-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISP & ASSOCIATES II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "CRISP",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-362-2990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHHH000063",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "GA",
            "license": "PHHH000063",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "GA",
            "license": "PHHH000063",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "GA",
            "license": "PHHH000063",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christians Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Compounding Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.