Active NPI
TDS Georgia, LLC
Doing business as Thomas Drug Store
- Community/Retail Pharmacy
- Thomasville, GA
National Provider Identifier
1295784270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHRE000780
- Legal business name
- TDS GEORGIA, LLC
- Doing business as
- Thomas Drug Store
- Practice address
- 108 S Broad Street
Thomasville, GA 31792-5541 - Phone
- (229) 226-2535
- Fax
- (229) 226-2537
- NPI assigned
- May 8, 2006
- Last updated
- Sep 3, 2026
- Organization subpart
- Yes
- Parent organization
- TDS GEORGIA, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anthony Ray Benton Jr., PHARMD
- Title
- Owner
- Phone
- (229) 226-4201
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | PHRE000780 | GA | Primary |
| Long Term Care Pharmacy | 3336L0003X | NU |
Addresses
Primary practice location
108 S Broad Street
Thomasville, GA 31792-5541
Mailing address
PO Box 350
Thomasville, GA 31799
Phone (229) 226-4201
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000037056A | Medicaid | GA | |
| 2134357 | Other | PK |
Other names 1
- Thomas Drug Store
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120801000533 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0547337784 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Thomasville, GA; Wrens, GA |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Thomas Drug Store
- Community/Retail Pharmacy
- Thomasville, GA
- NPI 1417980426
O20120801000533
National Provider Directory
National Provider Directory- Tax ID family
- Advanced Medical Group LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
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
- Thomasville, GA
- NPI 1508456971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788393600000",
"number": "1295784270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 350",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "31799",
"telephone_number": "229-226-4201",
"fax_number": "229-226-4206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 S BROAD STREET",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317925541",
"telephone_number": "229-226-2535",
"fax_number": "229-226-2537"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TDS GEORGIA, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TDS GEORGIA, LLC",
"enumeration_date": "2006-05-08",
"last_updated": "2026-09-03",
"certification_date": "2022-03-31",
"status": "A",
"authorized_official_last_name": "BENTON",
"authorized_official_first_name": "ANTHONY",
"authorized_official_middle_name": "RAY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "229-226-4201",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "GA",
"license": "PHRE000780",
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000037056A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2134357",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Thomas Drug Store",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Thomas Drug Store",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Thomasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.