Active NPI
Kathryn Tucker Farabow, RPH
- Pharmacist
- Douglas, GA
National Provider Identifier
1639771561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 016083
- Practice address
- 912 Ward St W
Douglas, GA 31533-3516 - Phone
- (912) 384-2088
- NPI assigned
- Nov 16, 2020
- Last updated
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 016083 | GA | Primary |
Addresses
Primary practice location
912 Ward St W
Douglas, GA 31533-3516
Mailing address
207 Farabow Rd
Broxton, GA 31519-3533
Phone (912) 389-5781
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016083 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy, L.L.C. | Current | Accepting new patients | |
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients |
Locations
912 Ward St W
Douglas, GA 31533
Phone (912) 384-2088
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1639771561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 FARABOW RD",
"city": "BROXTON",
"state": "GA",
"postal_code": "315193533",
"telephone_number": "912-389-5781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 WARD ST W",
"city": "DOUGLAS",
"state": "GA",
"postal_code": "315333516",
"telephone_number": "912-384-2088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARABOW",
"first_name": "KATHRYN",
"middle_name": "TUCKER",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "016083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.