Organization Active NPI

The Watts Co of Marianna Inc

  • Community/Retail Pharmacy
  • Marianna, FL
National Provider Identifier
1972601904
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THE WATTS CO OF MARIANNA INC
Practice address
4154 Lafayette St Ste G
St G
Marianna, FL 32446-5655
Phone
(850) 482-5781
Fax
(850) 482-6880
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Jim Watts
Title
President
Phone
(850) 482-5781

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH3054 FL
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4154 Lafayette St Ste G
St G
Marianna, FL 32446-5655

Mailing address

4154 Lafayette St Ste G
St G
Marianna, FL 32446-5655

Other identifiers 2

IdentifierTypeStateIssuer
1014391OtherOTHER ID NUMBER-COMMERCIAL NUMBER
101755100MedicaidFL

Other names 1

  • WACO DRUGS AND GIFTS Doing business as

National Provider Directory

National Provider Directory

Locations

4154 Lafayette St
Ste G
Marianna, FL 32446
Phone (850) 482-5781

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1972601904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4154 LAFAYETTE ST STE G",
            "address_2": "ST G",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324465655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4154 LAFAYETTE ST STE G",
            "address_2": "ST G",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324465655",
            "telephone_number": "850-482-5781",
            "fax_number": "850-482-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATTS CO OF MARIANNA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-482-5781"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH3054",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1014391",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101755100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WACO DRUGS AND GIFTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.