Charles Iverson Storey III, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH010218 Issued in GA

Practice address

145 N Main Ave
Pine Mountain, GA 31822-2454

Phone

(706) 663-2255

Fax

(706) 663-8026

NPI assigned

Nov 12, 2007

Last updated

Nov 12, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Mountain Pharmacy, Inc

  • Community/Retail Pharmacy
  • Pine Mountain, GA
  • NPI 1447280672
  NPD (past) Authorized official

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1821278441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX A",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318220500",
            "telephone_number": "706-663-2255",
            "fax_number": "706-663-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MAIN AVE",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318222454",
            "telephone_number": "706-663-2255",
            "fax_number": "706-663-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOREY",
        "first_name": "CHARLES",
        "middle_name": "IVERSON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH010218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACIST LICENSE",
            "identifier": "RPH010218",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffery A. Russell, DC
• Josh B Seward
• Christy Meacham Smith, NP
• Tamika Smith
• Spine Mountain Physical Therapy and Wellness Studio
• Malcolm Tatum, RPH
• Torianna Jabre Tucker
• Timothy Turco, PHD
• Soraya Walker
• Carisma Janique Williams, LMSW

• Pharmacist in Pine Mountain, GA
• Providers in Pine Mountain, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.