Armor Drugs LLC
Organization Active NPI Community/Retail Pharmacy · Valdosta, GA
NPI 1891842944 · NPPES record last updated Apr 17, 2017
Key facts
- NPI
- 1891842944
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHRE010075 (GA)
- Legal business name
- ARMOR DRUGS LLC
- Practice address
- 2704 N Oak St
Ste B1
Valdosta, GA 31602-1744 - Phone
- (229) 244-5353
- Fax
- (229) 244-5357
- NPI assigned
- Jan 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Adam Moore, PHARMD
- Title
- President
- Phone
- (229) 560-0005
Corporate family (same tax ID) 1
Practitioners 2
-
Adam Rhett Moore, PHARMD
-
Emily Wall Stamey, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110929000224 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 5698894996 | Practice locations: Valdosta, GA |
| O20161014001302 | GA | DME Supplier - Pharmacy | 0143518761 | Practice locations: Valdosta, GA |
| O20170126002028 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0143518761 | Practice locations: Valdosta, GA |
National Provider Directory
- Tax ID family
- Armor Drugs LLC
Locations
2704 N Oak St
Bldg B1
Valdosta, GA 31602
Phone (229) 244-5353
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHRE010075 | GA | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
2704 N Oak St
Ste B1
Valdosta, GA 31602-1744
Mailing address
2704 N Oak St
Ste B1
Valdosta, GA 31602-1744
Phone (229) 244-5353
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2148610 | Other | PK | |
| 000069429A | Medicaid | GA |
Other names
- Hogan's Pharmacy
Other providers in Valdosta, GA
- Applecare LLC
- Ar Psychiatric & Counseling Center LLC
- Are Medical, Inc
- Ogechukwu Ariwodo
- Armor Drugs LLC
- Rachel Kathleen Armstrong
- Ellie Rebecca Arnold
- Parker Arnold
- Tyler Arnold
- Judith Artis
All providers in Valdosta, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.