Individual provider Active NPI

Dennis Wayne Long, BS PHARMACY

  • Pharmacist
  • Smyrna, GA
National Provider Identifier
1316496409
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH016522 Issued in GA
Practice address
200 Technology CT SE
Suite B
Smyrna, GA 30082-5250
Phone
(770) 437-8040
Fax
(770) 437-8411
NPI assigned
Sep 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH016522 GA Primary

Addresses

Primary practice location

200 Technology CT SE
Suite B
Smyrna, GA 30082-5250

Mailing address

200 Technology CT SE
Suite B
Smyrna, GA 30082-5250
Phone (770) 437-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
RPH016522GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1316496409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECHNOLOGY CT SE",
            "address_2": "SUITE B",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825250",
            "telephone_number": "770-437-8040",
            "fax_number": "770-437-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TECHNOLOGY CT SE",
            "address_2": "SUITE B",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825250",
            "telephone_number": "770-437-8040",
            "fax_number": "770-437-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DENNIS",
        "middle_name": "WAYNE",
        "credential": "BS PHARMACY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH016522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.