NPIMap

Organization Active NPI

Walgreens Pharmacy

  • Clinical Medical Laboratory
  • College Park, GA
National Provider Identifier
1578846036
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
8 Issued in GA
Legal business name
WALGREENS PHARMACY
Practice address
6120 Old National Hwy
College Park, GA 30349-4367
Phone
(678) 536-4050
NPI assigned
Sep 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Latisia Brooks
Title
Pharmacist
Phone
(678) 536-4050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 8 GA Primary

Addresses

Primary practice location

6120 Old National Hwy
College Park, GA 30349-4367

Mailing address

6120 Old National Hwy
College Park, GA 30349-4367
Phone (678) 536-4050

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1578846036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 OLD NATIONAL HWY",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303494367",
            "telephone_number": "678-536-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 OLD NATIONAL HWY",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303494367",
            "telephone_number": "678-536-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "LATISIA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "678-536-4050",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.