Organization Active NPI

Holcomb Bridge Wellness Pharmacy Inc

  • Community/Retail Pharmacy
  • Roswell, GA
National Provider Identifier
1770041956
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HOLCOMB BRIDGE WELLNESS PHARMACY INC
Practice address
861 Holcomb Bridge Rd Ste 101
Roswell, GA 30076-1900
Phone
(470) 297-5749
Fax
(470) 297-5758
NPI assigned
Mar 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Dr Anselm Kwaku Addo, PHARMAD
Title
President/Owner
Phone
(678) 622-1032

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

861 Holcomb Bridge Rd Ste 101
Roswell, GA 30076-1900

Mailing address

861 Holcomb Bridge Rd Ste 101
Roswell, GA 30076-1900
Phone (678) 622-1032

Other identifiers 1

IdentifierTypeStateIssuer
003229122AMedicaidGA

National Provider Directory

National Provider Directory

Locations

220 Atlanta Rd
Cumming, GA 30040

220 Atlanta Rd
#A
Cumming, GA 30040
Phone (470) 297-5749

861 Holcomb Bridge Rd
Ste 101
Roswell, GA 30076
Phone (470) 297-5749

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1770041956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 HOLCOMB BRIDGE RD STE 101",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761900",
            "telephone_number": "678-622-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 HOLCOMB BRIDGE RD STE 101",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761900",
            "telephone_number": "470-297-5749",
            "fax_number": "470-297-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLCOMB BRIDGE WELLNESS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "ADDO",
        "authorized_official_first_name": "DR ANSELM",
        "authorized_official_middle_name": "KWAKU",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "678-622-1032",
        "authorized_official_credential": "PHARMAD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003229122A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.