NPIMap

Organization Active NPI

Social Circle Pharmacy and Supplies Inc.

  • Durable Medical Equipment & Medical Supplies
  • Social Circle, GA
National Provider Identifier
1790995850
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOCIAL CIRCLE PHARMACY AND SUPPLIES INC.
Doing business as
Social Circle Pharmacy and Supplies Inc
Practice address
1027 Bateman Dr # a
Social Circle, GA 30025-5025
Phone
(770) 464-4330
Fax
(770) 464-4323
NPI assigned
May 23, 2007
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Iroemeha C Ike, RPHNPI 1598357097
Title
President
Phone
(177) 026-5174

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Community/Retail Pharmacy 3336C0003X PHRE009152 GA

Addresses

Primary practice location

1027 Bateman Dr # a
Social Circle, GA 30025-5025

Mailing address

1027 Bateman Dr # a
Social Circle, GA 30025-5025
Phone (770) 464-4330

Other identifiers 1

IdentifierTypeStateIssuer
109904598AMedicaidGA

Other names 1

  • SOCIAL CIRCLE PHARMACY AND SUPPLIES INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930060376 GA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 7719182146 Practice locations: Social Circle, GA
O20250519001357 GA Part B Supplier - Mass Immunization (Roster Biller Only) 7719182146 Practice locations: Social Circle, GA

National Provider Directory

National Provider Directory
Tax ID family
Social Circle Pharmacy and Supplies Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1790995850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 BATEMAN DR # A",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300255025",
            "telephone_number": "770-464-4330",
            "fax_number": "770-464-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 BATEMAN DR # A",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300255025",
            "telephone_number": "770-464-4330",
            "fax_number": "770-464-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCIAL CIRCLE PHARMACY AND SUPPLIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "IKE",
        "authorized_official_first_name": "IROEMEHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "177-026-5174",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109904598A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOCIAL CIRCLE PHARMACY AND SUPPLIES INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Social Circle, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.