NPIMap

Organization Active NPI

Kennestone Hospital Inc

Doing business as WellStar Pharmacy Network

  • Community/Retail Pharmacy
  • Marietta, GA
National Provider Identifier
1699177428
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE010072 Issued in GA
Legal business name
KENNESTONE HOSPITAL INC
Doing business as
WellStar Pharmacy Network
Practice address
3747 Roswell Rd
Marietta, GA 30062-6215
Phone
(470) 956-0170
Fax
(678) 560-5948
NPI assigned
Sep 24, 2014
Last updated
Feb 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Snehal Doshi
Title
Vice President of Pharmacy
Phone
(470) 644-0392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE010072 GA Primary

Addresses

Primary practice location

3747 Roswell Rd
Marietta, GA 30062-6215

Mailing address

PO Box 743081
Atlanta, GA 30374-3081
Phone (470) 956-0170

Other identifiers 2

IdentifierTypeStateIssuer
003151812AMedicaidGA
2147795OtherPK

Other names 1

  • WellStar Pharmacy Network Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennestone Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1699177428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743081",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743081",
            "telephone_number": "470-956-0170",
            "fax_number": "678-560-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 ROSWELL RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626215",
            "telephone_number": "470-956-0170",
            "fax_number": "678-560-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESTONE HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "DOSHI",
        "authorized_official_first_name": "SNEHAL",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PHARMACY",
        "authorized_official_telephone_number": "470-644-0392"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003151812A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147795",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStar Pharmacy Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.