Organization Active NPI

Terese Inc

Doing business as Peach Orchard Drugs

  • Community/Retail Pharmacy
  • Augusta, GA
National Provider Identifier
1376558916
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009010 Issued in GA
Legal business name
TERESE INC
Doing business as
Peach Orchard Drugs
Practice address
2529 Peach Orchard Rd
Augusta, GA 30906-2412
Phone
(706) 798-3253
Fax
(706) 798-3225
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Authorized official

Name
Terese Fordham
Title
Owner, President
Phone
(706) 533-3369

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE009010 GA Primary

Addresses

Primary practice location

2529 Peach Orchard Rd
Augusta, GA 30906-2412

Mailing address

2529 Peach Orchard Rd
Augusta, GA 30906-2412
Phone (706) 798-3253

Other identifiers 2

IdentifierTypeStateIssuer
2016259OtherPK
787683075AMedicaidGA

Other names 1

  • PEACH ORCHARD DRUGS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1376558916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 PEACH ORCHARD RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062412",
            "telephone_number": "706-798-3253",
            "fax_number": "706-798-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 PEACH ORCHARD RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309062412",
            "telephone_number": "706-798-3253",
            "fax_number": "706-798-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "FORDHAM",
        "authorized_official_first_name": "TERESE",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "706-533-3369"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "787683075A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEACH ORCHARD DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.