Redan Community Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

REDAN COMMUNITY PHARMACY LLC

Practice address

4108 Redan Rd Ste a
Stone Mountain, GA 30083-5070

Phone

(678) 467-7844

NPI assigned

Jul 10, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mohamed Adan, PHARMDNPI 1336690312

Title

Pharmacist in Charge

Phone

(678) 467-7844

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamed Adan, PHARMD

  • Pharmacist
  • Evans, GA
  • NPI 1336690312
  NPD Authorized official

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1699393173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 REDAN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300835070",
            "telephone_number": "678-467-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 REDAN RD STE A",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300835070",
            "telephone_number": "678-467-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDAN COMMUNITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "ADAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "678-467-7844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "redanpharmacy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Practice email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4108 Redan Rd Ste A",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300835070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "redanpharmacy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "practice email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4108 Redan Rd Ste A",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300835070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nadege Raymond, RN, OWNER, DIRECTOR
• Thelsea Scott Raymonvil, LPC
• RBR Medical Supply Inc.
• Reaching Above Poverty
• Sherena Readous
• Rediclinic LLC
• Jerolyn N Redstrom, OTR
• Brandi Reed, LPC
• Deborah A Reed, RN-CNS/PMH
• Tameca Reed, MA, NCC, LPC

• Community/Retail Pharmacy in Stone Mountain, GA
• Providers in Stone Mountain, 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 Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.