Carrollton Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE008910 Issued in GA

Legal business name

CARROLLTON PHARMACY INC

Doing business as

Carrollton Pharmacy Inc

Practice address

105 Clinic Ave
Carrollton, GA 30117-4413

Phone

(770) 834-7733

Fax

(770) 834-7734

NPI assigned

Nov 28, 2006

Last updated

Nov 7, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dennis McCullough

Title

Owner

Phone

(770) 834-7733

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CARROLLTON PHARMACY INC Doing business as

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1750457925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174413",
            "telephone_number": "770-834-7733",
            "fax_number": "770-834-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174413",
            "telephone_number": "770-834-7733",
            "fax_number": "770-834-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLTON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-834-7733"
    },
    "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": "PHRE008910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1129041",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00300396A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARROLLTON PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Carrollton Orthopaedic Surgery Center
• Carrollton Pediatric Clinic, P.C. (Westcare Pediatric and Family Care)
• Carrollton Post Acute LLC
• Carrollton Speech Therapy LLC
• Carrollton Surgical Group, P. a.
• Joann L Carson
• Ann-Gelle Carter, MD

• Community/Retail Pharmacy in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.