SSC Affiliates Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE005987 Issued in GA

Legal business name

SSC AFFILIATES INC

Doing business as

Shepherd Apothecary

Practice address

2020 Peachtree Rd NW
Atlanta, GA 30309-1426

Phone

(404) 350-7743

Fax

(404) 350-7514

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Paul McGourk, PHARMD

Title

Manager

Phone

(404) 350-7743

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Shepherd Apothecary Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1588774392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091426",
            "telephone_number": "404-350-7743",
            "fax_number": "404-350-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091426",
            "telephone_number": "404-350-7743",
            "fax_number": "404-350-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC AFFILIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "MCGOURK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-350-7743",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "PHRE005987",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE005987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000498154A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000248069C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherd Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharada Sripathi, PT
• Sudhir Prem Srivastava, M.D.
• Bharath Srivatsa, M.D.
• Sumathi Srivatsa, M.D
• SS OB GYN, PA
• SSC Atlanta Operating Company LLC (Sandy Springs Health and Rehabilitation)
• SSC Equity Holdings LLC
• Joy Ssebikindu, LPC
• SSRX LLC
• Amelia St John, CPNP

• Community/Retail Pharmacy in Atlanta, GA
• Providers in Atlanta, 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 Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.