Organization Active NPI

K & Y Pharmacy, LLC

  • Community/Retail Pharmacy
  • Smyrna, GA
National Provider Identifier
1508292103
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
K & Y PHARMACY, LLC
Practice address
969 Windy Hill Rd SE
Suite a
Smyrna, GA 30080-2040
Phone
(770) 989-1332
Fax
(770) 989-1336
NPI assigned
Sep 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Authorized official

Name
Nadege P Charles
Title
Owner
Phone
(770) 989-1332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X GA Primary

Addresses

Primary practice location

969 Windy Hill Rd SE
Suite a
Smyrna, GA 30080-2040

Mailing address

969 Windy Hill Rd SE
Suite a
Smyrna, GA 30080-2040
Phone (770) 989-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210319002111 GA Part B Supplier - Mass Immunization (Roster Biller Only) 2163839077 Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

1815 S Cobb Dr SE
Ste 103
Marietta, GA 30060
Phone (770) 989-1332

969 Windy Hill Rd SE
Ste A
Smyrna, GA 30080
Phone (770) 989-1332

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1508292103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 WINDY HILL RD SE",
            "address_2": "SUITE A",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802040",
            "telephone_number": "770-989-1332",
            "fax_number": "770-989-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 WINDY HILL RD SE",
            "address_2": "SUITE A",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802040",
            "telephone_number": "770-989-1332",
            "fax_number": "770-989-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & Y PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "NADEGE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-989-1332"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.