Heart Pharmacy, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

9038 Issued in GA

Legal business name

HEART PHARMACY, INC

Practice address

706 Springdale Dr
Riverdale, GA 30274-2327

Phone

(770) 997-6500

Fax

(770) 909-0737

NPI assigned

Oct 23, 2006

Last updated

Dec 23, 2014By 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

Mr. Marvin Weyman Griffin Sr., RPH

Title

Ceo / Chief Pharmacist

Phone

(770) 997-6500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1609959766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 SPRINGDALE DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742327",
            "telephone_number": "770-997-6500",
            "fax_number": "770-909-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 SPRINGDALE DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742327",
            "telephone_number": "770-997-6500",
            "fax_number": "770-909-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "WEYMAN",
        "authorized_official_title_or_position": "CEO / CHIEF PHARMACIST",
        "authorized_official_telephone_number": "770-997-6500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "9038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1113238",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000054711A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.