NPIMap

Organization Active NPI

Northeast Pharmaceuticals, Inc.

  • Long Term Care Pharmacy
  • Rome, GA
National Provider Identifier
1821353657
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PHRE009839 Issued in GA
Legal business name
NORTHEAST PHARMACEUTICALS, INC.
Doing business as
Northeast Pharmaceuticals, Inc.
Practice address
6 Mathis Dr NW
Rome, GA 30165-1242
Phone
(706) 237-6306
Fax
(706) 622-2135
NPI assigned
Jul 9, 2012
Last updated
Jun 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Krystal Mims
Title
Director of Operations
Phone
(334) 356-7627

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X PHRE009839 GA Primary

Addresses

Primary practice location

6 Mathis Dr NW
Rome, GA 30165-1242

Mailing address

3480 Eastern Blvd
Montgomery, AL 36116-1700
Phone (334) 356-7627

Other identifiers 1

IdentifierTypeStateIssuer
1162611OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Northeast Pharmaceuticals, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Pharmaceuticals Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1821353657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 EASTERN BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361161700",
            "telephone_number": "334-356-7627",
            "fax_number": "334-356-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MATHIS DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651242",
            "telephone_number": "706-237-6306",
            "fax_number": "706-622-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHARMACEUTICALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "334-356-7627"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE009839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1162611",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Pharmaceuticals, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.