Active NPI
Brendon Street
- Pharmacy Technician
- Atlanta, GA
National Provider Identifier
1750048633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- G6C7C4Z4
- Practice address
- 1105 Research Center Drive Atlanta SW
Atlanta, GA 30331 - Phone
- (404) 260-7779
- Fax
- (404) 260-6311
- NPI assigned
- Nov 26, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | G6C7C4Z4 | GA | Primary |
Addresses
Primary practice location
1105 Research Center Drive Atlanta SW
Atlanta, GA 30331
Mailing address
6223 Kirkwood PL
Douglasville, GA 30134-3876
Phone (314) 709-8788
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 |
|---|---|---|---|
| G6C7C4Z4 | GA | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637884800000",
"number": "1750048633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6223 KIRKWOOD PL",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301343876",
"telephone_number": "314-709-8788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 RESEARCH CENTER DRIVE ATLANTA SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30331",
"telephone_number": "404-260-7779",
"fax_number": "404-260-6311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STREET",
"first_name": "BRENDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-26",
"last_updated": "2021-11-26",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "GA",
"license": "G6C7C4Z4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.