Garden Lakes Pharmacy, Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHRE008455 Issued in GA

Legal business name

GARDEN LAKES PHARMACY, INC.

Practice address

2022 Redmond Cir NW
Rome, GA 30165-1322

Phone

(706) 378-7945

Fax

(706) 378-7949

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Donald L. Henderson, R.PH.

Title

President

Phone

(706) 378-7946

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Garden Lakes 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.

• Garden Lakes Pharmacy

  • Pharmacy
  • Rome, GA
  • NPI 1750418265
  NPD tax ID

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609929025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 REDMOND CIR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651322",
            "telephone_number": "706-378-7945",
            "fax_number": "706-378-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 REDMOND CIR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651322",
            "telephone_number": "706-378-7945",
            "fax_number": "706-378-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN LAKES PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-378-7946",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHRE008455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1148217",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Gann, COTA/L CPAM
• Ricky Vinson Gann, MS, OTR/L
• Kevin Garcia Rosas, DC
• Garden Lakes Dentistry LLC
• Garden Lakes Pharmacy
• Farrah Gardner, NP
• Rahul Garg, MD
• Lindsey Blocker Garmon, NP-C
• William M Garner, N.P.
• Garone R Enterprises LLC Life Spring Counseling Center

• Pharmacist in Rome, GA
• Providers in Rome, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.