NPIMap

Organization Active NPI

Monfort Compounding Center

  • Pharmacist
  • Lawrenceville, GA
National Provider Identifier
1548353261
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8344 Issued in GA
Legal business name
MONFORT COMPOUNDING CENTER
Practice address
470 North Clayton Street
Suite 100
Lawrenceville, GA 30045
Phone
(770) 963-2813
Fax
(770) 962-0166
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
William Carter Gorman, RPHNPI 1265594964
Title
Owner
Phone
(770) 963-2813

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 8344 GA Primary

Addresses

Primary practice location

470 North Clayton Street
Suite 100
Lawrenceville, GA 30045

Mailing address

PO Box 821
Lawrenceville, GA 30046-0821
Phone (770) 963-2813

National Provider Directory

National Provider Directory

Locations

470 N Clayton St
Ste 100
Lawrenceville, GA 30046
Phone (770) 963-2813

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548353261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 821",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300460821",
            "telephone_number": "770-963-2813",
            "fax_number": "770-963-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTH CLAYTON STREET",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30045",
            "telephone_number": "770-963-2813",
            "fax_number": "770-962-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONFORT COMPOUNDING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-963-2813",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "8344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.