Active NPI
Mortar and Pestle, LLC
Doing business as Northside Drugs
- Community/Retail Pharmacy
- Thomaston, GA
National Provider Identifier
1295388981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MORTAR AND PESTLE, LLC
- Doing business as
- Northside Drugs
- Practice address
- 1109 Highway 19 N
Thomaston, GA 30286-2207 - Phone
- (706) 648-2181
- Fax
- (706) 648-6430
- NPI assigned
- Jul 22, 2019
- Last updated
- Jul 15, 2020
- 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
- Ryan Meeks, PHARMD
- Title
- Owner
- Phone
- (706) 298-2714
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1109 Highway 19 N
Thomaston, GA 30286-2207
Mailing address
1109 Highway 19 N
Thomaston, GA 30286-2207
Phone (706) 648-2181
Other names 1
- Northside Drugs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200806000738 | GA | Part B Supplier - Independent Clinical Laboratory | 0143498451 | Practice locations: Thomaston, GA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Mortar and Pestle LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba The Medicine Cabinet
- Community/Retail Pharmacy
- Lagrange, GA
- NPI 1710490891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563753600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1594771200000",
"number": "1295388981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 HIGHWAY 19 N",
"city": "THOMASTON",
"state": "GA",
"postal_code": "302862207",
"telephone_number": "706-648-2181",
"fax_number": "706-648-6430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 HIGHWAY 19 N",
"city": "THOMASTON",
"state": "GA",
"postal_code": "302862207",
"telephone_number": "706-648-2181",
"fax_number": "706-648-6430"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MORTAR AND PESTLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-22",
"last_updated": "2020-07-15",
"certification_date": "2020-07-15",
"status": "A",
"authorized_official_last_name": "MEEKS",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "706-298-2714",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Northside Drugs",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Northside Drugs",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Thomaston, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.