Organization Active NPI

Lowtide Pharmacy Atlanta LLC

  • Community/Retail Pharmacy
  • Oxford, GA
National Provider Identifier
1396658951
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LOWTIDE PHARMACY ATLANTA LLC
Practice address
91135 East Metro Pkwy
Oxford, GA 30054-4226
Phone
(470) 682-2068
Fax
(678) 750-1035
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Authorized official

Name
Dr. Kelechukwu Iteogu, PHARMD
Title
Pic/Managing Partner
Phone
(478) 954-2364

Specialties & licenses 2

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

Addresses

Primary practice location

91135 East Metro Pkwy
Oxford, GA 30054-4226

Mailing address

91135 East Metro Pkwy
Oxford, GA 30054-4226
Phone (470) 682-2068

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790208000000",
    "number": "1396658951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91135 EAST METRO PKWY",
            "city": "OXFORD",
            "state": "GA",
            "postal_code": "300544226",
            "telephone_number": "470-682-2068",
            "fax_number": "678-750-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91135 EAST METRO PKWY",
            "city": "OXFORD",
            "state": "GA",
            "postal_code": "300544226",
            "telephone_number": "470-682-2068",
            "fax_number": "678-750-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWTIDE PHARMACY ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "ITEOGU",
        "authorized_official_first_name": "KELECHUKWU",
        "authorized_official_title_or_position": "PIC/MANAGING PARTNER",
        "authorized_official_telephone_number": "478-954-2364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.