NPIMap

Organization Active NPI

Pruitthealth Pharmacy Services - Atlanta, Inc.

Doing business as PruittHealth Pharmacy Services - Atlanta

  • Community/Retail Pharmacy
  • Norcross, GA
National Provider Identifier
1346385333
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PRUITTHEALTH PHARMACY SERVICES - ATLANTA, INC.
Doing business as
PruittHealth Pharmacy Services - Atlanta
Practice address
1626 Jeurgens CT
Suite a
Norcross, GA 30093-2219
Phone
(678) 533-6459
Fax
(770) 931-5253
NPI assigned
Feb 20, 2007
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Neil L. Pruitt Jr.
Title
Chairman and Ceo
Phone
(770) 279-6200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1626 Jeurgens CT
Suite a
Norcross, GA 30093-2219

Mailing address

1626 Jeurgens CT
Suite a
Norcross, GA 30093-2219
Phone (678) 533-6459

Other identifiers 1

IdentifierTypeStateIssuer
295907416AMedicaidGA

Other names 1

  • PruittHealth Pharmacy Services - Atlanta Doing business as

National Provider Directory

National Provider Directory

Locations

1626 Jeurgens Ct
Bldg 100
Norcross, GA 30093

1626 Jeurgens Ct
Ste A
Norcross, GA 30093
Phone (678) 230-4348

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1346385333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "SUITE A",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "678-533-6459",
            "fax_number": "770-931-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "SUITE A",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "678-533-6459",
            "fax_number": "770-931-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH PHARMACY SERVICES - ATLANTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295907416A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Pharmacy Services - Atlanta",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth Pharmacy Services - Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.