Leland Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE005933 Issued in GA

Legal business name

LELAND PHARMACY INC

Doing business as

Mableton Pharmacy & Uniforms

Practice address

5390 Floyd Rd SW
Mableton, GA 30126-2216

Phone

(770) 948-3133

Fax

(770) 948-3660

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Pamala Smith Marquess

Title

Secretary/Treasurer

Phone

(770) 948-3133

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mableton Pharmacy & Uniforms Doing business as

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1457427791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5390 FLOYD RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262216",
            "telephone_number": "770-948-3133",
            "fax_number": "770-948-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5390 FLOYD RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262216",
            "telephone_number": "770-948-3133",
            "fax_number": "770-948-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LELAND PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "MARQUESS",
        "authorized_official_first_name": "PAMALA",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "770-948-3133"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE005933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139728",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00181816A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mableton Pharmacy & Uniforms",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mableton, GA
• Providers in Mableton, 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 Apr 23, 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.