Weavers Rocky Face Pharmacy Group Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010622 Issued in GA

Legal business name

WEAVERS ROCKY FACE PHARMACY GROUP INC

Doing business as

Weavers Rocky Face Pharmacy

Practice address

2600 Old Chattanooga Rd
Rocky Face, GA 30740-8511

Phone

(706) 259-0668

Fax

(706) 259-1890

NPI assigned

Apr 24, 2018

Last updated

Nov 1, 2018By 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

Paul P Bryant, RPH

Title

Cfo

Phone

(706) 260-7998

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WEAVERS ROCKY FACE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Taylor Mitchell, PHARMD

  • Pharmacist
  • Rocky Face, GA
  • NPI 1790372019
  NPD (past)

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1942798012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 TI PI LN",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307057786",
            "telephone_number": "706-259-0668",
            "fax_number": "706-971-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OLD CHATTANOOGA RD",
            "city": "ROCKY FACE",
            "state": "GA",
            "postal_code": "307408511",
            "telephone_number": "706-259-0668",
            "fax_number": "706-259-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEAVERS ROCKY FACE PHARMACY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-260-7998",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411968250A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEAVERS ROCKY FACE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Lynn Rayner
• Diane Ryland, CRNA
• Carmen Warren Shepard, LPC
• Lena Dijontala Ellanesha Washington
• Weaver Rocky Face Pharmacy P C (Weavers Rocky Face Pharmacy)
• Dawn Machelle Wilhite, ED.S., CCC-SLP

• Community/Retail Pharmacy in Rocky Face, GA
• Providers in Rocky Face, 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 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.