Divyo Health Solutions, Inc. - Store #2

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

DIVYO HEALTH SOLUTIONS, INC. - STORE #2

Practice address

1100 Old Ellis Road
Suite 100
Roswell, GA 30076

Phone

(855) 675-5200

NPI assigned

Sep 4, 2026

Last updated

Sep 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tony Rayfus

Title

Officer

Phone

(855) 675-5200

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1902715923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OLD ELLIS ROAD",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "855-675-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 OLD ELLIS ROAD",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "855-675-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVYO HEALTH SOLUTIONS, INC. - STORE #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "RAYFUS",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "855-675-5200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Compounding Pharmacy in Roswell, GA
• Providers in Roswell, GA by specialty
• Compounding Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.