Active NPI
Fred Eugene Purvis, GA RPH 10245
- Pharmacist
- Moultrie, GA
National Provider Identifier
1780770222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- GARPH10295
- Practice address
- Winn Dixie 101
103 Talmadge Dr
Moultrie, GA 31768 - Phone
- (229) 891-2555
- Fax
- (229) 890-9826
- NPI assigned
- Oct 4, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | GARPH10295 | GA | Primary |
Addresses
Primary practice location
Winn Dixie 101
103 Talmadge Dr
Moultrie, GA 31768
Mailing address
163 Hwy 37
Adel, GA 31620
Phone (229) 896-2637
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GARPH10295 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780770222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 HWY 37",
"city": "ADEL",
"state": "GA",
"postal_code": "31620",
"telephone_number": "229-896-2637",
"fax_number": "229-896-1302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WINN DIXIE 101",
"address_2": "103 TALMADGE DR",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "31768",
"telephone_number": "229-891-2555",
"fax_number": "229-890-9826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURVIS",
"first_name": "FRED",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "GA RPH 10245",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "GARPH10295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moultrie, GA
- Anika Sarah Procope, MD, MSC
- Pruitthealth - Magnolia Manor, LLC (PruittHealth - Magnolia Manor)
- Pruitthealth - Moultrie, LLC (PruittHealth - Moultrie)
- Pruitthealth - Sunrise, LLC (PruittHealth - Sunrise)
- Publix Super Markets Inc (Publix Pharmacy #1540)
- Jessica Kayla Purvis, LCSW
- Radiology Associates of Moultrie
- Radiology Associates of Moultrie LLC
- Derrick William Railey, FNP, AGACNP
- Rainbow Pediatrics Associates PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.