NPIMap

Organization Active NPI

Mimbs Drug Co.

Doing business as Dixie City Pharmacy # 5

  • Pharmacy
  • Gainesville, GA
National Provider Identifier
1700863347
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
008642 Issued in GA
Legal business name
MIMBS DRUG CO.
Doing business as
Dixie City Pharmacy # 5
Practice address
1079 Jesse Jewell Pkwy SW
Gainesville, GA 30501-6103
Phone
(770) 536-3108
Fax
(770) 536-2357
NPI assigned
Dec 26, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Eddie H Mimbs, RPH
Title
President
Phone
(770) 536-3108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 008642 GA Primary

Addresses

Primary practice location

1079 Jesse Jewell Pkwy SW
Gainesville, GA 30501-6103

Mailing address

1079 Jesse Jewell Pkwy SW
Gainesville, GA 30501-6103
Phone (770) 536-3108

Other identifiers 2

IdentifierTypeStateIssuer
1150173OtherIDNCPDP #
PHRE008642OtherGUSTATE LISC NO

Other names 1

  • Dixie City Pharmacy # 5 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dixie City Pharmacy 16 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1079 Jesse Jewell Pkwy SW
Gainesville, GA 30501
Phone (678) 971-1000

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1700863347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 JESSE JEWELL PKWY SW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305016103",
            "telephone_number": "770-536-3108",
            "fax_number": "770-536-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 JESSE JEWELL PKWY SW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305016103",
            "telephone_number": "770-536-3108",
            "fax_number": "770-536-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMBS DRUG CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-26",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MIMBS",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-536-3108",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "008642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "1150173",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NO",
            "identifier": "PHRE008642",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dixie City Pharmacy # 5",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.