Active NPI
Village Drug Shop at Advantage LLC
- Long Term Care Pharmacy
- Athens, GA
National Provider Identifier
1457932956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- VILLAGE DRUG SHOP AT ADVANTAGE LLC
- Practice address
- 240 Mitchell Bridge Rd
Athens, GA 30606-2043 - Phone
- (706) 850-4955
- Fax
- (706) 850-4958
- NPI assigned
- Apr 16, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christopher Ryan Thurmond, PHARMD
- Title
- Owner
- Phone
- (706) 548-4444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
240 Mitchell Bridge Rd
Athens, GA 30606-2043
Mailing address
240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone (706) 850-4955
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHRE010132 | Other | GA | PHARMACY LICENSE |
| 003158669A | Medicaid | GA |
Other names 1
- Village Drug Shop at Advantage LTC
National Provider Directory
National Provider DirectoryLocations
240 Mitchell Bridge Rd
Athens, GA 30606
Phone (706) 369-5745
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Athens, GA
- NPI 1538760681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1457932956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 MITCHELL BRIDGE RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062043",
"telephone_number": "706-850-4955",
"fax_number": "706-850-4958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 MITCHELL BRIDGE RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062043",
"telephone_number": "706-850-4955",
"fax_number": "706-850-4958"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE DRUG SHOP AT ADVANTAGE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-16",
"last_updated": "2023-03-07",
"certification_date": "2021-04-16",
"status": "A",
"authorized_official_last_name": "THURMOND",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "RYAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "706-548-4444",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "PHRE010132",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003158669A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Village Drug Shop at Advantage LTC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.