CPM Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009976 Issued in GA

Legal business name

CPM PHARMACY LLC

Practice address

3870 Medical Park Dr
Austell, GA 30106-1110

Phone

(678) 564-2233

Fax

(678) 401-4245

NPI assigned

Dec 26, 2013

Organization subpart

No

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

Authorized official

Name

Kati Gainous

Title

Pharmacy Program Administrator

Phone

(925) 621-2900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Rx Pharmacy 034 Doing business as

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1790106458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ADVANCED RX MANAGEMENT",
            "address_2": "4683 CHABOT DRIVE, SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "925-621-2909",
            "fax_number": "904-389-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 MEDICAL PARK DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "678-564-2233",
            "fax_number": "678-401-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPM PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "GAINOUS",
        "authorized_official_first_name": "KATI",
        "authorized_official_title_or_position": "PHARMACY PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "925-621-2900"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149245",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Rx Pharmacy 034",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie B Coon, CNP
• Christina Marie Cox, M.D.
• Jarvett Cox, PHARMD
• Sylvonne Kenyatta Cox, PA-C
• CPM Imaging, LLC
• CPM Surgery Center LLC
• Kewana Craig, MSN, APRN, FNP-BC
• Harper Lee Crawford, NP-C
• Crbappl Oral Surgery LLC
• Creative Connections Mobile Barbershop

• Community/Retail Pharmacy in Austell, GA
• Providers in Austell, 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 Jun 11, 2015; 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.