Active NPI
Aster Mengistie
- Pharmacist
- Marietta, GA
National Provider Identifier
1841667516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH023590
- Practice address
- 684 North Cobb Parkway
Marietta, GA 30062 - Phone
- (770) 427-4648
- NPI assigned
- Aug 28, 2015
- Last updated
- Aug 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH023590 | GA | Primary |
| Pharmacist | 183500000X | PH10907 | SC |
Addresses
Primary practice location
684 North Cobb Parkway
Marietta, GA 30062
Mailing address
3420 Lassiter Falls Dr NE
Marietta, GA 30062-4199
Phone (404) 786-2494
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH023590 | GA | MD | Pharmacist |
| PH10907 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440720000000",
"number": "1841667516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3420 LASSITER FALLS DR NE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300624199",
"telephone_number": "404-786-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "684 NORTH COBB PARKWAY",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30062",
"telephone_number": "770-427-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENGISTIE",
"first_name": "ASTER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-28",
"last_updated": "2015-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023590",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "PH10907",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.