Baze Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010285 Issued in GA

Legal business name

BAZE PHARMACY LLC

Doing business as

BAZE Specialty Pharmacy

Practice address

1526 E Forrest Ave Ste 102
East Point, GA 30344-6979

Phone

(404) 761-4448

Fax

(404) 761-7905

NPI assigned

Apr 25, 2016

Last updated

Mar 29, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Athelia EzeNPI 1316954001

Title

Owner

Phone

(662) 323-5033

Specialties & licenses 5

Addresses

Other identifiers 3

Other names 1

• BAZE Specialty Pharmacy Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Baze Specialty Pharmacy, LLC

  • Durable Medical Equipment & Medical Supplies
  • East Point, GA
  • NPI 1245781061
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Athelia Balams Eze, PHARM.D.

  • Pharmacist
  • Starkville, MS
  • NPI 1316954001
  Authorized official Same address or phone

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1689029951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 STARK RD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593613",
            "telephone_number": "662-323-5579",
            "fax_number": "662-323-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 E FORREST AVE STE 102",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303446979",
            "telephone_number": "404-761-4448",
            "fax_number": "404-761-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAZE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "EZE",
        "authorized_official_first_name": "ATHELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-323-5033"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010285",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE010285",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003177187A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158297",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003175529A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAZE Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barclay Light and Wellness LLC
• Shanicqua Barnes, CRANIALPROSTHESISSPE
• Andrea Barton, MA, CCC-SLP
• Faraz Bassari, D.C.
• Martin Mandela Baxter, M.D.
• Baze Specialty Pharmacy, LLC
• Demetric Bazi
• Beal Wellness LLC
• Ra'Jae Belton
• Kieira Necole Benton

• Community/Retail Pharmacy in East Point, GA
• Providers in East Point, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.