Duluth Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009996 Issued in GA

Legal business name

DULUTH PHARMACY LLC

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

Organization subpart

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Duluth pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003145071A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duluth pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duluth pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Laricka Dunbar
• Janet Stuckwish Dunwody, D.D.S.
• Binh Duong, PHARMD
• Hoa Duong, PHARMD

• Community/Retail Pharmacy in Duluth, GA
• Providers in Duluth, GA by specialty
• Community/Retail Pharmacy in Georgia

• 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.

Verify at the official NPI Registry.