NPIMap

Organization Active NPI

Dacula Medicine Center

  • Pharmacist
  • Dacula, GA
National Provider Identifier
1780761601
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14587 Issued in GA
Legal business name
DACULA MEDICINE CENTER
Practice address
2555 2ND Avenue North
Dacula, GA 30019-0016
Phone
(770) 339-1593
Fax
(770) 339-1682
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Billy M StoneNPI 1104790856
Title
Pharmacist/Owner
Phone
(770) 339-1593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 14587 GA Primary

Addresses

Primary practice location

2555 2ND Avenue North
Dacula, GA 30019-0016

Mailing address

PO Box 927
Dacula, GA 30019-0016
Phone (770) 339-1593

Other identifiers 1

IdentifierTypeStateIssuer
1136692OtherGANATIONAL BOARD OF PHARMAC

Other names 1

  • Dacula Pharmacy Doing business as

National Provider Directory

National Provider Directory

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780761601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 927",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300190016",
            "telephone_number": "770-339-1593",
            "fax_number": "770-339-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 2ND AVENUE NORTH",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300190016",
            "telephone_number": "770-339-1593",
            "fax_number": "770-339-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DACULA MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "770-339-1593",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "14587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD OF PHARMAC",
            "identifier": "1136692",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dacula Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

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