Riverside Discount Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

007401 Issued in GA

Legal business name

RIVERSIDE DISCOUNT PHARMACY

Practice address

705 S Gordon Rd
Ste a
Mableton, GA 30126

Phone

(770) 732-9342

Fax

(770) 732-9347

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Christopher Muomah

Title

President

Phone

(770) 732-9342

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1881751154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S GORDON RD",
            "address_2": "STE A",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "30126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S GORDON RD",
            "address_2": "STE A",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "30126",
            "telephone_number": "770-732-9342",
            "fax_number": "770-732-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DISCOUNT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "MUOMAH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-732-9342"
    },
    "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": "007401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1136933",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00506965B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1136933",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Lee Richardson
• Latoya Monique Ridley
• Paun P Rimtepathip, PHARM.D.
• River Rise, LLC
• Lindsey Ann Rivers, PHARM.D.
• Ania Rodney, MD
• Ivan Camilo Rodriguez Goire, DC
• Batryse Rollins, MSW
• Rebecca Lynn Sawallich, FNP
• Rachel Schambach, LPC

• Community/Retail Pharmacy in Mableton, GA
• Providers in Mableton, 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 Sep 12, 2007; 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.