NPIMap

Organization Active NPI

Village Pharmacy Inc

  • Community/Retail Pharmacy
  • Douglasville, GA
National Provider Identifier
1366767105
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009649 Issued in GA
Legal business name
VILLAGE PHARMACY INC
Practice address
3697 Highway 5 Ste 6
Douglasville, GA 30135-6901
Phone
(678) 501-5165
Fax
(678) 501-5170
NPI assigned
Apr 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Authorized official

Name
Christy Parker, PHARM.D.NPI 1255301438
Title
President
Phone
(678) 501-5165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009649 GA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

3697 Highway 5 Ste 6
Douglasville, GA 30135-6901

Mailing address

3697 Highway 5 Ste 6
Douglasville, GA 30135-6901
Phone (678) 501-5165

Other identifiers 2

IdentifierTypeStateIssuer
691432518AMedicaidGA
2124510OtherPK

Other names 1

  • Village Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

3697 Highway 5
Ste 6
Douglasville, GA 30135
Phone (678) 501-5165

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1366767105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3697 HIGHWAY 5 STE 6",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356901",
            "telephone_number": "678-501-5165",
            "fax_number": "678-501-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3697 HIGHWAY 5 STE 6",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356901",
            "telephone_number": "678-501-5165",
            "fax_number": "678-501-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-501-5165",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009649",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691432518A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124510",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.