Organization Active NPI

Palliative Pharmacy Solutions Inc

  • Long Term Care Pharmacy
  • Tucker, GA
National Provider Identifier
1679602452
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
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

Updated by the provider on Nov 19, 2019

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2020679OtherPK

Other names 1

  • PALLIATIVE PHARMACY SOLUTIONS INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210430002372 GA Part B Supplier - Mass Immunization (Roster Biller Only) 0446277685 Practice locations: Tucker, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2190359Palliative Pharmacy Solutions Inc2338 Main Street, Tucker, GA 30084Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.