Dogwood Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010367 Issued in GA

Legal business name

DOGWOOD PHARMACY LLC

Doing business as

Dogwood Pharmacy

Practice address

1909 US Highway 82 W Ste 11
Tifton, GA 31793-8213

Phone

(229) 256-2411

Fax

(229) 256-2488

NPI assigned

Jul 21, 2017

Organization subpart

Yes

Parent organization

DOGWOOD PHARMACY LLCAs reported in NPPES

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

Authorized official

Name

Laura Eugena Tyson, PHARMDNPI 1013005057

Title

President/Owner/Pharmacist

Phone

(229) 686-2620

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dogwood Pharmacy Doing business as

Part of

Dogwood Pharmacy LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Dogwood Pharmacy LLC

  dba Dogwood Pharmacy

  • Community/Retail Pharmacy
  • Nashville, GA
  • NPI 1336184514
  NPPES parent name

Practitioners 2

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

• Laura Eugena Tyson, PHARMD

  • Pharmacist
  • Nashville, GA
  • NPI 1013005057
  NPD (past) Authorized official
• Kaitlyn Kennedy Patterson, PHARMD

  • Pharmacist
  • Tifton, GA
  • NPI 1285221366
  NPD (past)

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500595200000",
    "number": "1528581402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N DAVIS ST",
            "city": "NASHVILLE",
            "state": "GA",
            "postal_code": "316391426",
            "telephone_number": "229-237-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 US HIGHWAY 82 W STE 11",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317938213",
            "telephone_number": "229-256-2411",
            "fax_number": "229-256-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOGWOOD PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOGWOOD PHARMACY LLC",
        "enumeration_date": "2017-07-21",
        "last_updated": "2017-07-21",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "EUGENA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER/PHARMACIST",
        "authorized_official_telephone_number": "229-686-2620",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE RETAIL PHARMACY LICENSE",
            "identifier": "PHRE010367",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dogwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Day, L.D.O
• Roxann Elaine Deen, FNP-C
• Sanjay Desai, DO
• Digestive Disorders & Liver Clinic of So Ga, PC
• DM. Me Medical Supply Company (DM. Me Medical Supply)
• Dogwood Pharmacy LTC
• Henry Clayton Dorminey Jr., M.D.
• Shyann Dorough, OTR/L
• Terresa Ann Dorsey, FNP
• Kelley P Douglas, MD

• Community/Retail Pharmacy in Tifton, GA
• Providers in Tifton, 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 Jul 21, 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.