Active NPI
Palliative Pharmacy Solutions Inc
- Long Term Care Pharmacy
- Tucker, GA
National Provider Identifier
1679602452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- PALLIATIVE PHARMACY SOLUTIONS INC
- Practice address
- 2338 Main St
Tucker, GA 30084-4413 - Phone
- (770) 934-2976
- Fax
- (770) 934-2978
- NPI assigned
- Mar 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Carr, PHARM D
- Title
- Owner
- Phone
- (770) 934-2976
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Compounding Pharmacy | 3336C0004X | |||
| Institutional Pharmacy | 3336I0012X | PHRE007383 | GA | |
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
2338 Main St
Tucker, GA 30084-4413
Mailing address
2338 Main St
Tucker, GA 30084-4413
Phone (770) 934-2976
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020679 | Other | PK |
Other names 1
- PALLIATIVE PHARMACY SOLUTIONS INC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210430002372 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0446277685 | Practice locations: Tucker, GA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2190359 | Palliative Pharmacy Solutions Inc | Certificate of waiver | Aug 12, 2026 |
National Provider Directory
National Provider DirectoryLocations
2338 Main St
Tucker, GA 30084
Phone (770) 934-2976
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Sandy Springs, GA
- NPI 1306145446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1574121600000",
"number": "1679602452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2338 MAIN ST",
"city": "TUCKER",
"state": "GA",
"postal_code": "300844413",
"telephone_number": "770-934-2976",
"fax_number": "770-934-2978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2338 MAIN ST",
"city": "TUCKER",
"state": "GA",
"postal_code": "300844413",
"telephone_number": "770-934-2976",
"fax_number": "770-934-2978"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALLIATIVE PHARMACY SOLUTIONS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-05",
"last_updated": "2019-11-19",
"status": "A",
"authorized_official_last_name": "CARR",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-934-2976",
"authorized_official_credential": "PHARM D"
},
"taxonomies": [
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336I0012X",
"taxonomy_group": "",
"desc": "Pharmacy, Institutional Pharmacy",
"state": "GA",
"license": "PHRE007383",
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2020679",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "PALLIATIVE PHARMACY SOLUTIONS INC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "PALLIATIVE PHARMACY SOLUTIONS INC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.