Active NPI
Griffin's Prescription Shop,Inc.
- Community/Retail Pharmacy
- Waycross, GA
National Provider Identifier
1356309348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHRE005627
- Legal business name
- GRIFFIN'S PRESCRIPTION SHOP,INC.
- Practice address
- 1408 Tebeau St
Waycross, GA 31501-5325 - Phone
- (912) 283-3010
- NPI assigned
- May 2, 2006
- 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
- Mr. Perry Donald Griffin, PHARMACIST
- Title
- President
- Phone
- (912) 283-3010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PHRE005627 | GA | Primary |
Addresses
Primary practice location
1408 Tebeau St
Waycross, GA 31501-5325
Mailing address
1408 Tebeau St
Waycross, GA 31501-5325
Phone (912) 283-3010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000022415A | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
1408 Tebeau St
Waycross, GA 31501
Phone (912) 283-3010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198195200000",
"number": "1356309348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1408 TEBEAU ST",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315015325",
"telephone_number": "912-283-3010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 TEBEAU ST",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315015325",
"telephone_number": "912-283-3010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRIFFIN'S PRESCRIPTION SHOP,INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-02",
"last_updated": "2007-12-21",
"status": "A",
"authorized_official_last_name": "GRIFFIN",
"authorized_official_first_name": "PERRY",
"authorized_official_middle_name": "DONALD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "912-283-3010",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "GA",
"license": "PHRE005627",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000022415A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waycross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.