Pine Mountain Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

158 Issued in GA

Legal business name

PINE MOUNTAIN PHARMACY, INC

Practice address

145 N Main Ave
Pine Mountain, GA 31822-0500

Phone

(706) 663-2255

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles Iverson Storey III, RPHNPI 1821278441

Title

President Owner

Phone

(706) 663-2255

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Charles Iverson Storey III, RPH

  • Pharmacist
  • Pine Mountain, GA
  • NPI 1821278441
  NPD (past) Authorized official

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447280672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX A",
            "address_2": "145 N MAIN AVE",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318220500",
            "telephone_number": "706-663-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MAIN AVE",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318220500",
            "telephone_number": "706-663-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE MOUNTAIN PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOREY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "IVERSON",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "706-663-2255",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1112969",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Christian Lowery, DMD
• Dustin Petry, DMD
• Pine Mountain Chiropractic Center, LLC
• Pine Mountain Eye Care
• Pine Mountain Family Dentistry, LLC
• Veta Rhonda Rodriguez, MS CHRISTIAN COUNSEL
• Jeffery A. Russell, DC
• Josh B Seward
• Christy Meacham Smith, NP
• Tamika Smith

• Community/Retail Pharmacy in Pine Mountain, GA
• Providers in Pine Mountain, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.