Whitlock Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE006953 Issued in GA

Legal business name

WHITLOCK PHARMACY INC

Practice address

3880 Due West Rd NW
Suite E
Marietta, GA 30064-1058

Phone

(770) 427-5647

Fax

(770) 514-7861

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Terry Shaw, PHARMD

Title

Owner Phcst

Phone

(770) 427-5647

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SHAW PHARMACY INC Doing business as

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1912068081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 DUE WEST RD NW",
            "address_2": "SUITE E",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 DUE WEST RD NW",
            "address_2": "SUITE E",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641058",
            "telephone_number": "770-427-5647",
            "fax_number": "770-514-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITLOCK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER PHCST",
        "authorized_official_telephone_number": "770-427-5647",
        "authorized_official_credential": "PHARMD"
    },
    "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": "PHRE006953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00430097A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1132935",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHAW PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shirley Gale White, L.C.S.W.
• J D Whitener Jr., DDS
• Alexander Whitfield, PT, DPT
• Sharon Whiting, SERVICE COORDINATOR
• Whitlock Dental Care
• Laura Whitney
• Xena Antoinette Whittier, M.D.
• Tiffany C Whittington, LPC
• Natasha Gabrielle Whittley
• Doris Whitworth

• Community/Retail Pharmacy in Marietta, GA
• Providers in Marietta, 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 Mar 25, 2009; 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.