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
- 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 and National Provider Directory roles.
-
- Pharmacy
- Pooler, GA
- NPI 1578009130
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.