Clinic Drug Store, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHRE003303 Issued in GA

Legal business name

CLINIC DRUG STORE, INC.

Doing business as

Clinic Drug Store

Practice address

1001 E Forsyth St
Americus, GA 31709-3721

Phone

(229) 924-2783

Fax

(229) 924-9220

NPI assigned

Aug 2, 2016

Last updated

Aug 2, 2016By 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

Lee Pinnell

Title

Owner

Phone

(229) 942-5170

Specialties & licenses 2

Addresses

Other names 1

• CLINIC DRUG STORE Doing business as

Tax ID family

Clinic Drug Store2 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.

• Clinic Drug Store, Inc.

  dba Plains Pharmacy

  • Long Term Care Pharmacy
  • Plains, GA
  • NPI 1144749847
  NPD tax ID

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1265985667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317090445",
            "telephone_number": "229-924-2783",
            "fax_number": "229-924-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E FORSYTH ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093721",
            "telephone_number": "229-924-2783",
            "fax_number": "229-924-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "PINNELL",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-942-5170"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE003303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINIC DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Hope Christian, MS, RDN, LDN
• Stephanie Irene Clark
• Porsche Clayton
• Vanessa Cliatt
• Clinic Drug Store, Inc.
• Eric N Codner, DC
• Langly Jordan Coleman
• Vickie B Collier, RDH
• Brandy Michelle Collins, PA-C
• Nancy O Collins, LPN

• Long Term Care Pharmacy in Americus, GA
• Providers in Americus, GA by specialty
• Long Term Care Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.