Monfort Drug Company

Primary specialty

PharmacistTaxonomy code 183500000X

License

5529 Issued in GA

Legal business name

MONFORT DRUG COMPANY

Practice address

470 North Clayton Street
Suite 101
Lawrenceville, GA 30045

Phone

(770) 963-2438

Fax

(770) 963-0166

NPI assigned

Oct 3, 2006

Last updated

Aug 22, 2020By 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

Mr. William Carter Gorman, RPHNPI 1265594964

Title

Owner

Phone

(770) 963-2438

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• William Carter Gorman, R.PH.

  • Pharmacist
  • Lawrenceville, GA
  • NPI 1265594964
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336234855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300460821",
            "telephone_number": "770-963-2438",
            "fax_number": "770-963-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTH CLAYTON STREET",
            "address_2": "SUITE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30045",
            "telephone_number": "770-963-2438",
            "fax_number": "770-963-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONFORT DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-963-2438",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "5529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00032227A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hira Asif Momin
• Lubna Rizvan Momin
• Laura Moncada
• Monfort Compounding Center
• Monfort Drug and Compounding Company Inc
• Vivian Mong
• Carlina Monroy
• Samuel Montague
• Yolanda M Monteiro, LPC
• Aldemar Montero, M.D.

• Pharmacist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.