Olde Time Pharmacy Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OLDE TIME PHARMACY INC

Doing business as

Olde Time Pharmacy

Practice address

402 Argonne Terrace
Suite 230
Holly Springs, GA 30115

Phone

(770) 783-0483

Fax

(770) 881-7910

NPI assigned

Oct 26, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Noell, RPH

Title

President

Phone

(770) 313-7615

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• OLDE TIME PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1578648705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HIGHLANDS DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ARGONNE TERRACE",
            "address_2": "SUITE 230",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "30115",
            "telephone_number": "770-783-0483",
            "fax_number": "770-881-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDE TIME PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "NOELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-313-7615",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009088",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1155084",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLDE TIME PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Allen Mills, M.D.
• Joanna Miragaya, MD, PHD
• Holley Noel, NCC, LAPC
• Olde Time Pharmacy at Sixes LLC
• Olde Time Pharmacy at Sixes, LLC
• Outlast Sports Rehabilitation, LLC
• Eva Poon, M.D.
• Hannah Elizabeth Reed, MS, LAPC, NCC
• Stephanie Reeves, RBT
• Revived Medical Spa LLC

• Durable Medical Equipment & Medical Supplies in Holly Springs, GA
• Providers in Holly Springs, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.