Organization Active NPI

Express Food & Pharmacy Investment LLC

  • Community/Retail Pharmacy
  • Atlanta, GA
National Provider Identifier
1285022277
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
EXPRESS FOOD & PHARMACY INVESTMENT LLC
Doing business as
Express food and Pharmacy
Practice address
2111 Campbellton Rd SW
Atlanta, GA 30311-4605
Phone
(404) 755-4232
Fax
(404) 753-0032
NPI assigned
Dec 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Mr. Uday RajguruNPI 1306127717
Title
Pharmacist
Phone
(404) 755-4232

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 1

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

Addresses

Primary practice location

2111 Campbellton Rd SW
Atlanta, GA 30311-4605

Mailing address

1067 Pearl Mist Dr SW
Lilburn, GA 30047-5496
Phone (678) 933-8965

Other names 1

  • Express food and Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200701001547 GA Part B Supplier - Mass Immunization (Roster Biller Only) 0244651511 Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

2111 Campbellton Rd SW
Atlanta, GA 30311
Phone (404) 755-4232

Practitioners & affiliated clinicians

Practitioners 3

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": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1285022277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 PEARL MIST DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300475496",
            "telephone_number": "678-933-8965",
            "fax_number": "404-818-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 CAMPBELLTON RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303114605",
            "telephone_number": "404-755-4232",
            "fax_number": "404-753-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS FOOD & PHARMACY INVESTMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "RAJGURU",
        "authorized_official_first_name": "UDAY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "404-755-4232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Express food and Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Express food and Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.