Organization Active NPI

Shannon Pharmacy

  • Community/Retail Pharmacy
  • Rome, GA
National Provider Identifier
1386748333
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE008861 Issued in GA
Legal business name
SHANNON PHARMACY
Doing business as
SHANNON PHARMACY
Practice address
5855 New Calhoun Hwy NE
Rome, GA 30161-8253
Phone
(706) 295-4772
Fax
(706) 295-2866
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Christopher Coker, RPHNPI 1487049383
Title
Owner
Phone
(706) 295-4772

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
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE008861 GA Primary

Addresses

Primary practice location

5855 New Calhoun Hwy NE
Rome, GA 30161-8253

Mailing address

5855 New Calhoun Hwy NE
Rome, GA 30161-8253
Phone (706) 295-4772

Other identifiers 2

IdentifierTypeStateIssuer
779754709AMedicaidGA
2015642OtherPK

Other names 1

  • SHANNON PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230428002088 GA Part B Supplier - Pharmacy 5496110330 Practice locations: Rome, GA

National Provider Directory

National Provider Directory

Locations

5855 New Calhoun Hwy NE
Rome, GA 30161
Phone (706) 295-4772

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1386748333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 NEW CALHOUN HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301618253",
            "telephone_number": "706-295-4772",
            "fax_number": "706-295-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 NEW CALHOUN HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301618253",
            "telephone_number": "706-295-4772",
            "fax_number": "706-295-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "COKER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-295-4772",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE008861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "779754709A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2015642",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHANNON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.