Eagle's Landing Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE007404 Issued in GA

Legal business name

EAGLE'S LANDING PHARMACY

Practice address

1090 Eagle's Landing Pkwy
Stockbridge, GA 30281

Phone

(770) 474-5005

Fax

(770) 474-8093

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Thomas Rink, RPH

Title

President

Phone

(770) 474-5005

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1558585463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 EAGLE'S LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-474-5005",
            "fax_number": "770-474-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 EAGLE'S LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-474-5005",
            "fax_number": "770-474-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE'S LANDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "RINK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-474-5005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE007404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000507515B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000507515A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E-Z Ride Home Transportation Services LLC
• Eagle Chiropractic Clinic Inc
• Eagle's Landing Longevity Center
• Eagle's Landing OB GYN 2 LLC
• Eagle's Landing Pharmacy
• Eagle's Wings Healthcare Services, Inc.
• Eagles Landing Diabetes and Endocrinology (None)
• Eagles Landing Gastroenterology P.C.
• Eagles Landing Medical Center (Multi Specialist Practice)
• Eagles Landing Multi Speciality Group,LLC

• Community/Retail Pharmacy in Stockbridge, GA
• Providers in Stockbridge, 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 27, 2015; 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.