Main Street Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHRE009935 Issued in GA

Legal business name

MAIN STREET PHARMACY

Practice address

3070 N Main St NW
Kennesaw, GA 30144-2756

Phone

(678) 269-6476

NPI assigned

Jun 25, 2013

Organization subpart

No

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

Authorized official

Name

Tami Chamblee Oliver

Title

Pharmacy Manager

Phone

(678) 793-2525

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1407295330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N MAIN ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442756",
            "telephone_number": "678-269-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N MAIN ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442756",
            "telephone_number": "678-269-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "CHAMBLEE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "678-793-2525"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHRE009935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.