Active NPI
Omega Pharmacy LLC
- Community/Retail Pharmacy
- Omega, GA
National Provider Identifier
1396709507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 4464
- Legal business name
- OMEGA PHARMACY LLC
- Practice address
- 246 Oak St
Omega, GA 31775-3087 - Phone
- (229) 528-4276
- Fax
- (229) 528-4278
- NPI assigned
- Apr 14, 2006
- Last updated
- Jan 30, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jackson Thomas Lindsey, RPH
- Title
- Pharmacist
- Phone
- (229) 528-4276
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 4464 | GA | Primary |
Addresses
Primary practice location
246 Oak St
Omega, GA 31775-3087
Mailing address
PO Box 98
246 Oak Street
Omega, GA 31775-0098
Phone (229) 528-4276
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000032821A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091014000405 | GA | Part B Supplier - Other | 1759427230 | Practice locations: Omega, GA |
| O20100930071197 | GA | DME Supplier - Pharmacy | 1759427230 | Practice locations: Omega, GA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2172935 | Omega Pharmacy | Certificate of waiver | Oct 1, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Omega Pharmacy LLC | Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Nebulizer Equipment and/or Supplies | Does not accept assignment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Omega, GA
- NPI 1164058566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1485734400000",
"number": "1396709507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 98",
"address_2": "246 OAK STREET",
"city": "OMEGA",
"state": "GA",
"postal_code": "317750098",
"telephone_number": "229-528-4276",
"fax_number": "229-528-4278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 OAK ST",
"city": "OMEGA",
"state": "GA",
"postal_code": "317753087",
"telephone_number": "229-528-4276",
"fax_number": "229-528-4278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OMEGA PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-14",
"last_updated": "2017-01-30",
"status": "A",
"authorized_official_last_name": "LINDSEY",
"authorized_official_first_name": "JACKSON",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "229-528-4276",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "GA",
"license": "4464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000032821A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Omega, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.