Osaretin Peggy Omoregie, PHARM D

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RPH032874 Issued in GA

Practice address

4200 Salem Rd
Covington, GA 30016-4533

Phone

(678) 212-3195

NPI assigned

Nov 4, 2021

Last updated

Nov 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1912662974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WOODBERRY PL",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300345548",
            "telephone_number": "678-235-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SALEM RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164533",
            "telephone_number": "678-212-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOREGIE",
        "first_name": "OSARETIN",
        "middle_name": "PEGGY",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "RPH032874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Covington, GA
• Providers in Covington, 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 Nov 4, 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.

Verify at the official NPI Registry.