Active NPI
Duluth Pharmacy LLC
Doing business as Duluth pharmacy
- Community/Retail Pharmacy
- Duluth, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHRE009996
- Legal business name
- DULUTH PHARMACY LLC
- Doing business as
- Duluth pharmacy
- Practice address
- 3890 Pleasant Hill Rd Ste 103
Duluth, GA 30096-4807 - Phone
- (770) 476-2820
- Fax
- (770) 476-2811
- NPI assigned
- Mar 6, 2014
- Last updated
- Jun 9, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Badrinath Jayanthi
- Title
- Pharmacist
- Phone
- (678) 254-9200
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PHRE009996 | GA | Primary |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
3890 Pleasant Hill Rd Ste 103
Duluth, GA 30096-4807
Mailing address
3890 Pleasant Hill Rd Ste 101B
Duluth, GA 30096-4807
Phone (177) 047-6282
Other names 1
- Duluth pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150402001278 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 5092032946 | Practice locations: Duluth, GA |
National Provider Directory
National Provider DirectoryLocations
3890 Pleasant Hill Rd
#101B
Duluth, GA 30096
Phone (770) 476-2820
3890 Pleasant Hill Rd
Ste 101B
Duluth, GA 30096
Phone (770) 476-2820
3890 Pleasant Hill Rd
Ste 103
Duluth, GA 30096
Phone (770) 476-2820
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Duluth, GA
- NPI 1831480904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394064000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1654732800000",
"number": "1285050823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3890 PLEASANT HILL RD STE 101B",
"city": "DULUTH",
"state": "GA",
"postal_code": "300964807",
"telephone_number": "177-047-6282",
"fax_number": "770-476-2811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3890 PLEASANT HILL RD STE 103",
"city": "DULUTH",
"state": "GA",
"postal_code": "300964807",
"telephone_number": "770-476-2820",
"fax_number": "770-476-2811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DULUTH PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-03-06",
"last_updated": "2022-06-09",
"certification_date": "2022-06-09",
"status": "A",
"authorized_official_last_name": "JAYANTHI",
"authorized_official_first_name": "BADRINATH",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "678-254-9200",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "GA",
"license": "PHRE009996",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Duluth pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Duluth pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.