NPIMap

Organization Active NPI

JM Cardinal Investments LLC Medical Quarters

Doing business as Concord Medical Quarters Pharmacy Corp

  • Community/Retail Pharmacy
  • Atlanta, GA
National Provider Identifier
1801810155
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE006381 Issued in GA
Legal business name
JM CARDINAL INVESTMENTS LLC MEDICAL QUARTERS
Doing business as
Concord Medical Quarters Pharmacy Corp
Practice address
5555 Peachtree Dunwoody Rd
Atlanta, GA 30350
Phone
(404) 252-3607
Fax
(404) 252-5183
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Willie D Smith
Title
Owner
Phone
(678) 463-9598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE006381 GA Primary

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd
Atlanta, GA 30350

Mailing address

8612 Main St
Woodstock, GA 30188-4829
Phone (678) 285-0760

Other identifiers 1

IdentifierTypeStateIssuer
00322858-FMedicaidGA

Other names 1

  • Concord Medical Quarters Pharmacy Corp Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Concord Drugs4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1801810155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 MAIN ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884829",
            "telephone_number": "678-285-0760",
            "fax_number": "770-971-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30350",
            "telephone_number": "404-252-3607",
            "fax_number": "404-252-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JM CARDINAL INVESTMENTS LLC MEDICAL QUARTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-463-9598"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE006381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00322858-F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Medical Quarters Pharmacy Corp",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concord Medical Quarters Pharmacy Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.