NPIMap

Organization Active NPI

Moye'S Pharmacy, Inc.

  • Pharmacist
  • Stockbridge, GA
National Provider Identifier
1881035582
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHRE008280 Issued in GA
Legal business name
MOYE'S PHARMACY, INC.
Practice address
4467 N Henry Blvd
Stockbridge, GA 30281-3656
Phone
(770) 474-0704
Fax
(770) 507-4121
NPI assigned
Jul 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Authorized official

Name
Mr. Loren B Pierce, RPH
Title
Owner
Phone
(770) 474-7693

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X PHRE008280 GA Primary

Addresses

Primary practice location

4467 N Henry Blvd
Stockbridge, GA 30281-3656

Mailing address

106 Rock Quarry Rd Ste B
Stockbridge, GA 30281-3766
Phone (770) 474-7693

Other identifiers 2

IdentifierTypeStateIssuer
000262457AMedicaidGA
NCPDPOtherGA1127403

Other names 1

  • Moye's Pharmacy- Jodeco Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130827000217 GA Part B Supplier - Mass Immunization (Roster Biller Only) 7214054907 7 other NPIs on this enrollment
Practice locations: McDonough, GA; Locust Grove, GA; Jackson, GA; Hampton, GA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4467 N Henry Blvd
Stockbridge, GA 30281
Phone (770) 474-0704

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1881035582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 ROCK QUARRY RD STE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813766",
            "telephone_number": "770-474-7693",
            "fax_number": "770-692-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4467 N HENRY BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302813656",
            "telephone_number": "770-474-0704",
            "fax_number": "770-507-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOYE'S PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-474-7693",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHRE008280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000262457A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1127403",
            "identifier": "NCPDP",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moye's Pharmacy- Jodeco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.