Active NPI
Suraphael S Tilahun
- Pharmacist
- Thomson, GA
National Provider Identifier
1902569486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH033369
- Practice address
- 668 Main St
Thomson, GA 30824-7416 - Phone
- (706) 595-1667
- NPI assigned
- Oct 20, 2021
- Last updated
- Oct 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH033369 | GA | Primary |
Addresses
Primary practice location
668 Main St
Thomson, GA 30824-7416
Mailing address
668 Main St
Thomson, GA 30824-7416
Phone (706) 595-1667
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 |
|---|---|---|---|
| RPH033369 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
668 Main St
Thomson, GA 30824
Phone (706) 595-1667
Organizations & group practices 2
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": "1634688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1902569486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "668 MAIN ST",
"city": "THOMSON",
"state": "GA",
"postal_code": "308247416",
"telephone_number": "706-595-1667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "668 MAIN ST",
"city": "THOMSON",
"state": "GA",
"postal_code": "308247416",
"telephone_number": "706-595-1667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILAHUN",
"first_name": "SURAPHAEL",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-20",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH033369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thomson, GA
- Thomson Drug Company LLC
- Thomson Family Dental, LLC
- Thomson Lung, LLC
- Thomson Orthopedics & Sports Medicine PC
- Thomson Podiatry Associates, PC
- Total Renal Care Inc (McDuffie Dialysis)
- True Results Diagnostics LLC
- Lori Roth Tucker, FNP
- Umg General Surgery LLC (UMG General Surgery)
- Umg Neurosurgery LLC (University Neuroscience Augusta Back)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.