NPIMap

Organization Active NPI

Rextox Consultant LLC

  • Community/Retail Pharmacy
  • Conyers, GA
National Provider Identifier
1255800132
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
REXTOX CONSULTANT LLC
Doing business as
Retox Healing Hands Pharmacy
Practice address
1810 Highway 20 SE Ste 174
Conyers, GA 30013-2001
Phone
(678) 478-9511
NPI assigned
Nov 20, 2018
Organization subpart
Yes
Parent organization
RETOX HEALING HANDS PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Authorized official

Name
Raphael Ogunsusi, PHARMACYNPI 1881943793
Title
Owner
Phone
(678) 478-9511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

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

Addresses

Primary practice location

1810 Highway 20 SE Ste 174
Conyers, GA 30013-2001

Mailing address

2630 Wellington Way SE
Conyers, GA 30013-6413
Phone (678) 478-9511

Other names 1

  • Retox Healing Hands Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rextox Consultant LLC2 organizations share this tax ID, including this one
Part of
Rextox Consultant LLC

Other organizations with this tax ID 1

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

Locations

1810 Highway 20 SE
Ste 174
Conyers, GA 30013
Phone (678) 478-9511

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542672000000",
    "number": "1255800132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 WELLINGTON WAY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136413",
            "telephone_number": "678-478-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 HIGHWAY 20 SE STE 174",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132001",
            "telephone_number": "678-478-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REXTOX CONSULTANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RETOX HEALING HANDS PHARMACY",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A",
        "authorized_official_last_name": "OGUNSUSI",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-478-9511",
        "authorized_official_credential": "PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Retox Healing Hands Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.