Convenient RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010309 Issued in GA

Legal business name

CONVENIENT RX LLC

Doing business as

Convenient Care Pharmacy #4

Practice address

640 Veterans Pkwy N
Moultrie, GA 31788

Phone

(229) 890-6054

Fax

(229) 891-4087

NPI assigned

Sep 14, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Greg Yarbrough, RPH

Title

Owner

Phone

(229) 668-3005

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CONVENIENT CARE PHARMACY #4 Doing business as

Locations

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1295283620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 861",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317760861",
            "telephone_number": "229-668-3005",
            "fax_number": "229-668-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 VETERANS PKWY N",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31788",
            "telephone_number": "229-890-6054",
            "fax_number": "229-891-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "YARBROUGH",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-668-3005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003188228A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LIC NUMBER",
            "identifier": "PHRE010309",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONVENIENT CARE PHARMACY #4",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CONVENIENT CARE PHARMACY #4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Andrew G Cordista, MD

• Community/Retail Pharmacy in Moultrie, GA
• Providers in Moultrie, 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 Mar 30, 2020; 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.