NPIMap

Organization Active NPI

Rite Aid Pharmacy

  • Pharmacist
  • Douglasville, GA
National Provider Identifier
1619358736
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH027466 Issued in GA
Legal business name
RITE AID PHARMACY
Practice address
3687 Highway 5
Douglasville, GA 30135-2385
Phone
(770) 577-8979
NPI assigned
Jun 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Jessica Raven Northcutt, PHARMD
Title
Pharmacist
Phone
(615) 238-7279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X RPH027466 GA Primary

Addresses

Primary practice location

3687 Highway 5
Douglasville, GA 30135-2385

Mailing address

3687 Highway 5
Douglasville, GA 30135-2385
Phone (770) 577-8979

National Provider Directory

National Provider Directory
Tax ID family
Rite Aid 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.

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1619358736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352385",
            "telephone_number": "770-577-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3687 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352385",
            "telephone_number": "770-577-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "NORTHCUTT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "RAVEN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "615-238-7279",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH027466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.