Presbyterian Home Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHRE005010 Issued in GA

Legal business name

PRESBYTERIAN HOME PHARMACY INC

Doing business as

Presbyterian Home Pharmacy

Practice address

1901 W Screven St
Quitman, GA 31643-3913

Phone

(229) 263-6130

Fax

(229) 263-6169

NPI assigned

Jan 30, 2007

Last updated

Dec 8, 2020By 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

Alex Patterson, MS

Title

Exctv Dir

Phone

(229) 263-6101

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PRESBYTERIAN HOME PHARMACY Doing business as

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1760528285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316430407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W SCREVEN ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316433913",
            "telephone_number": "229-263-6130",
            "fax_number": "229-263-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOME PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "EXCTV DIR",
        "authorized_official_telephone_number": "229-263-6101",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE005010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142579B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2017528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRESBYTERIAN HOME PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Priority Wellness
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• Long Term Care Pharmacy in Quitman, GA
• Providers in Quitman, GA by specialty
• Long Term Care Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.