Individual provider Active NPI

Eric L Mullins

  • Pharmacotherapy Pharmacist
  • Dahlonega, GA
National Provider Identifier
1578779237
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
020994 Issued in GA
Practice address
24 Alicia LN
Dahlonega, GA 30533-1612
Phone
(706) 867-0514
Fax
(706) 867-0533
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0000011614 TN
Pharmacotherapy Pharmacist 1835P1200X 020994 GA Primary

Addresses

Primary practice location

24 Alicia LN
Dahlonega, GA 30533-1612

Mailing address

3802 Covered Bridge PL
Gainesville, GA 30506-2062
Phone (678) 450-5962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0000011614TNMDPharmacist
020994GAMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1578779237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 COVERED BRIDGE PL",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305062062",
            "telephone_number": "678-450-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ALICIA LN",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331612",
            "telephone_number": "706-867-0514",
            "fax_number": "706-867-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "ERIC",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000011614",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "GA",
            "license": "020994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.