NPIMap

Organization Active NPI

Spectrum Healthcare Solutions LLC

  • Community/Retail Pharmacy
  • Snellville, GA
National Provider Identifier
1649589581
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009695 Issued in GA
Legal business name
SPECTRUM HEALTHCARE SOLUTIONS LLC
Practice address
3151 Lenora Church Rd
Suite 600
Snellville, GA 30039-4818
Phone
(678) 344-0148
Fax
(888) 559-9575
NPI assigned
Sep 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Victor Jemison
Title
President/Ceo
Phone
(678) 344-0148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009695 GA Primary

Addresses

Primary practice location

3151 Lenora Church Rd
Suite 600
Snellville, GA 30039-4818

Mailing address

3151 Lenora Church Rd
Suite 600
Snellville, GA 30039-4818
Phone (678) 344-0148

Other identifiers 1

IdentifierTypeStateIssuer
1160376OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Spectrum Healthcare Solutions LLC Doing business as

National Provider Directory

National Provider Directory

Locations

3151 Lenora Church Rd
Ste 600
Snellville, GA 30039
Phone (678) 344-0148

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1649589581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 LENORA CHURCH RD",
            "address_2": "SUITE 600",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394818",
            "telephone_number": "678-344-0148",
            "fax_number": "888-559-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 LENORA CHURCH RD",
            "address_2": "SUITE 600",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300394818",
            "telephone_number": "678-344-0148",
            "fax_number": "888-559-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTHCARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "JEMISON",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "678-344-0148"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1160376",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Healthcare Solutions LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.