Broxton Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010064 Issued in GA

Legal business name

BROXTON PHARMACY LLC

Doing business as

Broxton Pharmacy,LLC

Practice address

402 Alabama St N
Broxton, GA 31519-6001

Phone

(912) 359-2362

Fax

(912) 359-3607

NPI assigned

Jun 23, 2014

Last updated

Sep 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Freddie Pridgen

Title

Owner

Phone

(912) 359-2362

Specialties & licenses 1

Addresses

Other names 1

• Broxton Pharmacy,LLC Doing business as

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1801201447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ALABAMA ST N",
            "city": "BROXTON",
            "state": "GA",
            "postal_code": "315196001",
            "telephone_number": "912-359-2362",
            "fax_number": "912-359-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ALABAMA ST N",
            "city": "BROXTON",
            "state": "GA",
            "postal_code": "315196001",
            "telephone_number": "912-359-2362",
            "fax_number": "912-359-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROXTON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "FREDDIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-359-2362"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broxton Pharmacy,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Broxton Family Pharmacy LLC
• Terri Rae Cater, FNP-BC
• Anslee Morgan Collins
• Bridgett De'Neisha Davis
• Filipinas Durano, M.D.
• Family Medical Associates-Claxton, Inc (Broxton Family Medical Associates)

• Community/Retail Pharmacy in Broxton, GA
• Providers in Broxton, 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 Sep 8, 2014; 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.