Organization Active NPI

Griffin's Prescription Shop,Inc.

  • Community/Retail Pharmacy
  • Waycross, GA
National Provider Identifier
1356309348
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE005627 Issued in GA
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

Updated by the provider on Dec 21, 2007

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000022415AMedicaidGA

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.