NPIMap

Organization Active NPI

Southern Family Markets LLC

Doing business as Southern Family Market

  • Community/Retail Pharmacy
  • Macon, GA
National Provider Identifier
1689810095
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009541 Issued in GA
Legal business name
SOUTHERN FAMILY MARKETS LLC
Doing business as
Southern Family Market
Practice address
1425 Rocky Creek Rd
Macon, GA 31206-3575
Phone
(478) 788-3054
NPI assigned
Jan 7, 2009
Last updated
Oct 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Authorized official

Name
Mark Tow
Title
Director of Pharmacy
Phone
(205) 912-4934

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009541 GA Primary

Addresses

Primary practice location

1425 Rocky Creek Rd
Macon, GA 31206-3575

Mailing address

PO Box 8500
Lockbox 8531
Philadelphia, PA 19178-8531

Other identifiers 2

IdentifierTypeStateIssuer
369558283AMedicaidGA
1158179OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Southern Family Market Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Family Market27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

1425 Rocky Creek Rd
Macon, GA 31206
Phone (478) 788-3054

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1689810095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX 8531",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 ROCKY CREEK RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312063575",
            "telephone_number": "478-788-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FAMILY MARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "TOW",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "205-912-4934"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369558283A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1158179",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Family Market",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.