Self-Med RX Clayton Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE002710 Issued in GA

Legal business name

SELF-MED RX CLAYTON DRUG INC

Doing business as

Clayton Pharmacy

Practice address

100 S Main St
Clayton, GA 30525-5480

Phone

(706) 782-3211

Fax

(706) 782-0705

NPI assigned

Oct 10, 2006

Last updated

Apr 1, 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

Mike Addington

Title

Pic

Phone

(706) 782-3211

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CLAYTON PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1285722710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "address_2": "C/O SEF MED RX",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "30525",
            "telephone_number": "706-782-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MAIN ST",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305255480",
            "telephone_number": "706-782-3211",
            "fax_number": "706-782-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF-MED RX CLAYTON DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "ADDINGTON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "706-782-3211"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE002710",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012111",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00025033A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLAYTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey R Scott, LPC
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• Lori T Sego, PHARMACIST
• Elizabeth Newton Seib, LMFT
• Lisa Simmons, PHARM.D.
• Margaret Leigh Singer, NP
• Kathy Sloan, RN
• Amanda Dawn Smith
• Patricia H Smith, NP-C

• Community/Retail Pharmacy in Clayton, GA
• Providers in Clayton, 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 Apr 1, 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.