Walmart Pharmacy #1070

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

12398 Issued in GA

Legal business name

WALMART PHARMACY #1070

Practice address

88 Highland Xing
East Ellijay, GA 30540-6052

Phone

(706) 276-1180

NPI assigned

May 29, 2014

Last updated

May 29, 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

Robyn Carter, RPH

Title

Staff Pharmacist

Phone

(706) 502-2374

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1629480298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 RIVEREDGE LN # 9061",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305405390",
            "telephone_number": "706-502-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HIGHLAND XING",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305406052",
            "telephone_number": "706-276-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART PHARMACY #1070",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "706-502-2374",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "GA",
            "license": "12398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Gary Tomblin, PH.D.
• Marie Therese Vazquez, PTA
• Wal-Mart Stores East, LP (Vision Center 30-1070)
• Loretta Walborn, PHARM.D.
• Walgreen Co (Walgreens #17697)

• Community Health Clinic/Center in East Ellijay, GA
• Providers in East Ellijay, GA by specialty
• Community Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.