Leeland Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHRE005933 Issued in GA

Legal business name

LEELAND PHARMACY

Doing business as

MABLETON PHARMACY & UNIFORMS

Practice address

5390 Floyd Rd SW
Mableton, GA 30126-2216

Phone

(770) 948-3133

Fax

(770) 948-3660

NPI assigned

Apr 6, 2018

Organization subpart

No

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

Authorized official

Name

Jonathan Marquess

Title

Owner

Phone

(770) 948-3133

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MABLETON PHARMACY & UNIFORMS Doing business as

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1699272641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 MAIN ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884829",
            "telephone_number": "678-285-0760",
            "fax_number": "770-971-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5390 FLOYD RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262216",
            "telephone_number": "770-948-3133",
            "fax_number": "770-948-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEELAND PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "MARQUESS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-948-3133"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE005933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176496",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000181816A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MABLETON PHARMACY & UNIFORMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanette Latimore, RPH
• Shronna Latimore
• Lauretta Louis Healthcare
• Akida Lavender, LPC
• Yohayra Lee
• Glynis Leflore, LPN
• Leland Pharmacy Inc
• Liberty Healthcare Services Inc
• Liberty Healthcare Servises Inc.
• Lifelinks Resources LLC

• Long Term Care Pharmacy in Mableton, GA
• Providers in Mableton, GA by specialty
• Long Term Care Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.