Active NPI
Antonio Green
- Pharmacist
- McDonough, GA
National Provider Identifier
1659094894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH032817
- Practice address
- 2 N Zack Hinton Pkwy
McDonough, GA 30253-2317 - Phone
- (770) 957-2984
- NPI assigned
- Sep 22, 2022
- Last updated
- Sep 22, 2022
- Sex
- Male
- 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 | RPH032817 | GA | Primary |
Addresses
Primary practice location
2 N Zack Hinton Pkwy
McDonough, GA 30253-2317
Mailing address
2 N Zack Hinton Pkwy
McDonough, GA 30253-2317
Phone (770) 957-2984
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH032817 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1659094894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 N ZACK HINTON PKWY",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302532317",
"telephone_number": "770-957-2984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 N ZACK HINTON PKWY",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302532317",
"telephone_number": "770-957-2984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ANTONIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-22",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH032817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.