NPIMap

Organization Active NPI

Mortar and Pestle, LLC

Doing business as The Medicine Cabinet

  • Community/Retail Pharmacy
  • Lagrange, GA
National Provider Identifier
1720333743
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009864 Issued in GA
Legal business name
MORTAR AND PESTLE, LLC
Doing business as
The Medicine Cabinet
Practice address
300 Mooty Bridge Road
Lagrange, GA 30240
Phone
(706) 225-4930
Fax
(706) 298-4931
NPI assigned
Jul 16, 2012
Last updated
Jul 15, 2020By the provider in NPPES
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 MeeksNPI 1467953638
Title
Owner
Phone
(706) 298-2714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PHRE009864 GA Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

300 Mooty Bridge Road
Lagrange, GA 30240

Mailing address

300 Mooty Bridge Road
Lagrange, GA 30240
Phone (706) 298-4930

Other identifiers 2

IdentifierTypeStateIssuer
003128157AMedicaidGA
2136600OtherPK

Other names 1

  • The Medicine Cabinet Doing business as

National Provider Directory

National Provider Directory

Locations

300 Mooty Bridge Rd
Ste 112
Lagrange, GA 30240
Phone (706) 945-8351

Practitioners & affiliated clinicians

Practitioners 2

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": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1720333743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOOTY BRIDGE ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-298-4930",
            "fax_number": "706-298-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOOTY BRIDGE ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-225-4930",
            "fax_number": "706-298-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTAR AND PESTLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-16",
        "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"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009864",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003128157A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136600",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Cabinet",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.