Active NPI
Dominic Maison
- Pharmacist
- Marietta, GA
National Provider Identifier
1740938810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH031110
- Practice address
- 3405 Dallas Hwy SW
Marietta, GA 30064-6425 - Phone
- (404) 990-3499
- NPI assigned
- Mar 16, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH031110 | GA | Primary |
Addresses
Primary practice location
3405 Dallas Hwy SW
Marietta, GA 30064-6425
Mailing address
3651 Monticello St
Douglasville, GA 30135-7721
Phone (678) 557-0922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH031110 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Need for Care Pharmacy, LLC | Current | Accepting new patients |
Locations
3405 Dallas Hwy SW
Marietta, GA 30064
Phone (404) 644-7731
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Marietta, GA
- NPI 1942873435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1740938810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3651 MONTICELLO ST",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301357721",
"telephone_number": "678-557-0922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3405 DALLAS HWY SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300646425",
"telephone_number": "404-990-3499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAISON",
"first_name": "DOMINIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-16",
"last_updated": "2022-03-16",
"certification_date": "2022-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH031110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.