NPIMap

Organization Active NPI

Bennett's Hometown Pharmacy - Waynesville, LLC

  • Community/Retail Pharmacy
  • Waynesville, GA
National Provider Identifier
1598969271
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009147 Issued in GA
Legal business name
BENNETT'S HOMETOWN PHARMACY - WAYNESVILLE, LLC
Practice address
26826 Hwy 82
Waynesville, GA 31566
Phone
(912) 778-3784
NPI assigned
Jun 14, 2007
Last updated
Jul 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Authorized official

Name
Mrs. Denise Bennett, R.PH.NPI 1255316899
Title
Pharmacist
Phone
(912) 462-3784

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 PHRE009147 GA
Community/Retail Pharmacy 3336C0003X PHRE009147 GA Primary

Addresses

Primary practice location

26826 Hwy 82
Waynesville, GA 31566

Mailing address

PO Box 1321
Nahunta, GA 31553-1321
Phone (912) 778-3784

Other identifiers 1

IdentifierTypeStateIssuer
735642371CMedicaidGA

National Provider Directory

National Provider Directory

Locations

26826 Highway 82
Waynesville, GA 31566
Phone (912) 778-3784

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": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1598969271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1321",
            "city": "NAHUNTA",
            "state": "GA",
            "postal_code": "315531321",
            "telephone_number": "912-778-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26826 HWY 82",
            "city": "WAYNESVILLE",
            "state": "GA",
            "postal_code": "31566",
            "telephone_number": "912-778-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT'S HOMETOWN PHARMACY - WAYNESVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "912-462-3784",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "PHRE009147",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "735642371C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; 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.