NPIMap

Organization Active NPI

Allmond & Whipple, Inc.

Doing business as City Drug Store

  • Community/Retail Pharmacy
  • Vidalia, GA
National Provider Identifier
1578601563
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE003762 Issued in GA
Legal business name
ALLMOND & WHIPPLE, INC.
Doing business as
City Drug Store
Practice address
1704 Meadows LN
Vidalia, GA 30474-8913
Phone
(912) 537-4147
Fax
(912) 537-1914
NPI assigned
Feb 2, 2007
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Mr. Benjamin R Black, RPHNPI 1275576837
Title
Pharmacist/Owner
Phone
(912) 537-4147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PHRE003762 GA
Community/Retail Pharmacy 3336C0003X PHRE003762 GA Primary

Addresses

Primary practice location

1704 Meadows LN
Vidalia, GA 30474-8913

Mailing address

1704 Meadows LN
Vidalia, GA 30474-8913
Phone (912) 537-4147

Other identifiers 1

IdentifierTypeStateIssuer
1115321OtherGANCPDP

Other names 1

  • City Drug Store Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930030390 GA DME Supplier - PharmacyDME Supplier - Orthotic Personnel 1658497383 Practice locations: Vidalia, GA
O20190324000003 GA Part B Supplier - Pharmacy 1658497383 Practice locations: Vidalia, GA

National Provider Directory

National Provider Directory
Tax ID family
Allmond Whipple Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1578601563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 MEADOWS LN",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748913",
            "telephone_number": "912-537-4147",
            "fax_number": "912-537-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MEADOWS LN",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748913",
            "telephone_number": "912-537-4147",
            "fax_number": "912-537-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLMOND & WHIPPLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "912-537-4147",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "PHRE003762",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE003762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1115321",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.