NPIMap

Organization Active NPI

Mortar and Pestle, LLC

Doing business as The Medicine Cabinet

  • Community/Retail Pharmacy
  • Lagrange, GA
National Provider Identifier
1710490891
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE010403 Issued in GA
Legal business name
MORTAR AND PESTLE, LLC
Doing business as
The Medicine Cabinet
Practice address
1704 Roanoke Rd
Lagrange, GA 30240-3803
Phone
(706) 298-4935
Fax
(706) 298-4934
NPI assigned
Nov 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Ryan Meeks, PHARMD
Title
Owner
Phone
(706) 298-2714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE010403 GA Primary

Addresses

Primary practice location

1704 Roanoke Rd
Lagrange, GA 30240-3803

Mailing address

300 Mooty Bridge Rd Ste 208
Lagrange, GA 30240-1881
Phone (706) 298-4935

Other names 1

  • The Medicine Cabinet Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2182026Medicine Cabinet Pharmacy, the1704 Roanoke Road, Lagrange, GA 30240Certificate of waiverApr 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Mortar and Pestle LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

300 Mooty Bridge Rd
Ste 208
Lagrange, GA 30240

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1710490891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOOTY BRIDGE RD STE 208",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302401881",
            "telephone_number": "706-298-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 ROANOKE RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403803",
            "telephone_number": "706-298-4935",
            "fax_number": "706-298-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTAR AND PESTLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "MEEKS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-298-2714",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Cabinet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.