Active NPI
Kwaku Fenin
- Pharmacist
- Union City, GA
National Provider Identifier
1912596222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH021498
- Practice address
- 3940 Jonesboro Rd
Union City, GA 30291-2258 - Phone
- (770) 774-1161
- Fax
- (779) 774-4461
- NPI assigned
- Jan 12, 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 | RPH021498 | GA | Primary |
Addresses
Primary practice location
3940 Jonesboro Rd
Union City, GA 30291-2258
Mailing address
3940 Jonesboro Rd
Union City, GA 30291-2258
Phone (770) 774-1161
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 |
|---|---|---|---|
| RPH021498 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy L.L.C | Past | Accepting new patients | |
| Georgia CVS Pharmacy, L.L.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1912596222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3940 JONESBORO RD",
"city": "UNION CITY",
"state": "GA",
"postal_code": "302912258",
"telephone_number": "770-774-1161",
"fax_number": "779-774-4461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 JONESBORO RD",
"city": "UNION CITY",
"state": "GA",
"postal_code": "302912258",
"telephone_number": "770-774-1161",
"fax_number": "779-774-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENIN",
"first_name": "KWAKU",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-12",
"last_updated": "2021-01-12",
"certification_date": "2021-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH021498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.