Ocilla Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE003436 Issued in GA

Legal business name

OCILLA PHARMACY, INC.

Doing business as

Ocilla Pharmacy

Practice address

515 N Irwin Ave
Ocilla, GA 31774-5007

Phone

(229) 468-5929

Fax

(229) 468-7313

NPI assigned

Jan 11, 2007

Last updated

Oct 11, 2021By 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

John D Price, PHARMDNPI 1003925264

Title

Pharmacist/Owner

Phone

(229) 468-5929

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ocilla Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Tax ID family

Ocilla Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ocilla Pharmacy, Inc.

  • Long Term Care Pharmacy
  • Ocilla, GA
  • NPI 1790332906
  NPD tax ID

Locations

Practitioners 2

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.

• John D Price, PHARMD, RPH

  • Pharmacist
  • Ocilla, GA
  • NPI 1003925264
  NPD Authorized official
• James Michael Wilson, R.PH.

  • Pharmacist
  • Ocilla, GA
  • NPI 1063562940
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1609926500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N IRWIN AVE",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317745007",
            "telephone_number": "229-468-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N IRWIN AVE",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317745007",
            "telephone_number": "229-468-5929",
            "fax_number": "229-468-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCILLA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "229-468-5929",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHRE003436",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE003436",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE003436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00032744A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ocilla Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stepheny Natasha Meyokee Lott Jones
• Howard C McMahan, MD
• Antonio McRoy
• Maci Merritt, FNP-C
• Hayden Nelms, LPC
• Ocilla Pharmacy, Inc.
• Osceola Health Care, Inc
• Dana P Paulk, MED CCC-SLP
• Mary Paulk
• Kayla Phillips

• Community/Retail Pharmacy in Ocilla, GA
• Providers in Ocilla, 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 Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.