Organization Active NPI

Moyes Pharmacy Inc

  • Community/Retail Pharmacy
  • Jackson, GA
National Provider Identifier
1912409475
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE010428 Issued in GA
Legal business name
MOYES PHARMACY INC
Practice address
227 S Mulberry St
Jackson, GA 30233-2058
Phone
(770) 957-5561
Fax
(678) 792-4866
NPI assigned
Mar 1, 2018
Last updated
Dec 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Loren PierceNPI 1053470351
Title
Ceo/Owner
Phone
(770) 474-7693

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE010428 GA Primary

Addresses

Primary practice location

227 S Mulberry St
Jackson, GA 30233-2058

Mailing address

PO Box 580
McDonough, GA 30253-0580
Phone (770) 474-7693

Other identifiers 2

IdentifierTypeStateIssuer
2176248OtherPK
003202981AMedicaidGA

Other names 1

  • Moye's Pharmacy - Jackson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130827000217 GA Part B Supplier - Mass Immunization (Roster Biller Only) 7214054907 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McDonough, GA; Locust Grove, GA; Jackson, GA; Hampton, GA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2185318Moyes Pharmacy227 South Mulberry Street, Jackson, GA 30233Certificate of waiverJun 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Moyes Pharmacy Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

34 E Main St S
Hampton, GA 30228
Phone (770) 946-5172

227 S Mulberry St
Jackson, GA 30233
Phone (770) 957-5561

3798 Highway 42 S
Locust Grove, GA 30248
Phone (770) 957-6004

85 Claire Ct
McDonough, GA 30252
Phone (404) 519-8268

106 Rock Quarry Rd
Ste A
Stockbridge, GA 30281
Phone (770) 507-1559

1920 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (770) 507-1234

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1912409475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302530580",
            "telephone_number": "770-474-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 S MULBERRY ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302332058",
            "telephone_number": "770-957-5561",
            "fax_number": "678-792-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOYES PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "LOREN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "770-474-7693"
    },
    "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": "PHRE010428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176248",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003202981A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moye's Pharmacy - Jackson",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.