Nba Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010160 Issued in GA

Legal business name

NBA PHARMACY LLC

Doing business as

Dawson Pharmacy

Practice address

66 S 400 Center LN
Suite 125
Dawsonville, GA 30534-6183

Phone

(706) 265-3934

Fax

(706) 265-8463

NPI assigned

Jul 8, 2015

Organization subpart

No

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

Authorized official

Name

Ashish Patel

Title

Pharmacy Manager

Phone

(706) 265-7193

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• DAWSON PHARMACY Doing business as

Locations

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.

• Surya N Vangapandu

  • Pharmacist
  • Marietta, GA
  • NPI 1033438676
  NPD

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1457734410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 PASATIEMPO LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247621",
            "telephone_number": "404-234-1800",
            "fax_number": "706-265-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 S 400 CENTER LN",
            "address_2": "SUITE 125",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346183",
            "telephone_number": "706-265-3934",
            "fax_number": "706-265-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NBA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "706-265-7193"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010160",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168970A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152987",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAWSON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dawsonville, GA
• Providers in Dawsonville, 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 Mar 13, 2017; 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.