Community Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COMMUNITY PHARMACY, INC.

Practice address

575 Glynn St N
Fayetteville, GA 30214-1198

Phone

(770) 461-3911

Fax

(770) 461-1121

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ralph W. Balchin, R.PH.NPI 1750971321

Title

Owner

Phone

(770) 461-3911

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jones Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ralph Waldo Balchin Jr., PHARMACIST

  • Pharmacist
  • Fayetteville, GA
  • NPI 1750971321
  NPD Authorized official
• Mitzi Matthews Gary

  • Pharmacist
  • Fayetteville, GA
  • NPI 1790375657
  NPD (past)
• Joan Mangarelli, RPH

  • Pharmacist
  • Fayetteville, GA
  • NPI 1376134015
  NPD (past)
• Catherine Cailyn Worley, PHARM.D.

  • Pharmacist
  • Fayetteville, GA
  • NPI 1174112247
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1972680361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 GLYNN ST N",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141198",
            "telephone_number": "770-461-3911",
            "fax_number": "770-461-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 GLYNN ST N",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141198",
            "telephone_number": "770-461-3911",
            "fax_number": "770-461-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "BALCHIN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-461-3911",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000454638A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jones Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jones Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Collins
• Kenneth Ray Collins Jr., D.D.S.
• William Collins, MD
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• Community Wellness and Intervention
• Complete Back and Body Care, Inc.
• Millicent Cone
• Joy Lynn Conklin, M.S., LPC, NCC, NSCC
• Barbara J Conlon, NP

• Community/Retail Pharmacy in Fayetteville, GA
• Providers in Fayetteville, 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 Jun 21, 2021; 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.