Living Well Pharmacy #2 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LIVING WELL PHARMACY #2 INC

Practice address

824 Gi Maddox Pkwy
Suite B
Chatsworth, GA 30705-2073

Phone

(706) 517-1901

Fax

(706) 517-2541

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Paul Phillip Bryant

Title

Cfo

Phone

(706) 422-9355

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Living Well Express Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Jeff Viktora

  • Pharmacist
  • Chatsworth, GA
  • NPI 1578776878
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1396852935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 TI PI LN",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307057786",
            "telephone_number": "706-517-1901",
            "fax_number": "706-517-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 GI MADDOX PKWY",
            "address_2": "SUITE B",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052073",
            "telephone_number": "706-517-1901",
            "fax_number": "706-517-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL PHARMACY #2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-422-9355"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHRE008958",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411552342A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Well Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Living Well Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Milagro Knowles, RN
• Mary Kwee, APRN
• Tonya Leonard
• Jeffery Lewis, CADCII
• Lifetouch Chiropractic LLC
• Kimberly Lacynthia Logan, APRN
• Chia CHI Loh, MBBS
• Tiffany Suzanne Longley
• Lookout Mountain Community Services
• James Daniel Loughridge

• All providers in Chatsworth, GA
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.