Prominence Pharmacy PC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010263 Issued in GA

Legal business name

PROMINENCE PHARMACY PC

Practice address

131 Prominence CT Ste 140
Dawsonville, GA 30534-8933

Phone

(706) 265-1332

Fax

(706) 265-1333

NPI assigned

Feb 4, 2016

Organization subpart

No

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

Authorized official

Name

Yohannes Haile

Title

President

Phone

(706) 265-1332

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Prominence pharmacy Doing business as

Locations

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1821456997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 PROMINENCE CT STE 140",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348933",
            "telephone_number": "706-265-1332",
            "fax_number": "706-265-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 PROMINENCE CT STE 140",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305348933",
            "telephone_number": "706-265-1332",
            "fax_number": "706-265-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMINENCE PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "HAILE",
        "authorized_official_first_name": "YOHANNES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-265-1332"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003172822A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157940",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prominence pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dawsonville, GA
• Providers in Dawsonville, 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 Apr 17, 2017; 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.