Active NPI
Emmanuela Medrea, RPH
- Pharmacist
- Peachtree Corners, GA
National Provider Identifier
1679863435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 020362
- Practice address
- 5895 Peachtree Pkwy
Peachtree Corners, GA 30092 - Phone
- (678) 421-9599
- NPI assigned
- Apr 13, 2011
- 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 | 020362 | GA | Primary |
Addresses
Primary practice location
5895 Peachtree Pkwy
Peachtree Corners, GA 30092
Mailing address
4458 Fairemoore Walk
Suwanee, GA 30024-6958
Phone (770) 280-7817
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 |
|---|---|---|---|
| 020362 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1679863435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4458 FAIREMOORE WALK",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300246958",
"telephone_number": "770-280-7817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5895 PEACHTREE PKWY",
"city": "PEACHTREE CORNERS",
"state": "GA",
"postal_code": "30092",
"telephone_number": "678-421-9599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDREA",
"first_name": "EMMANUELA",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-13",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "020362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree Corners, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.