Scott and Mary Hartzog, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009128 Issued in GA

Legal business name

SCOTT AND MARY HARTZOG, LLC

Doing business as

Seminole Hartzog Pharmacy

Practice address

111 E 2ND St
Donalsonville, GA 39845-1601

Phone

(229) 524-5364

Fax

(229) 524-8798

NPI assigned

Mar 5, 2007

Last updated

Sep 24, 2022By 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

Mr. Scott Hartzog, RPHNPI 1790564680

Title

Owner

Phone

(229) 524-2223

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Seminole Hartzog Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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.

• Scott Hartzog, RPH

  • Pharmacist
  • Donalsonville, GA
  • NPI 1790564680
  NPD Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663977600000",
    "number": "1982733267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "DONALSONVILLE",
            "state": "GA",
            "postal_code": "398450337",
            "telephone_number": "229-524-5364",
            "fax_number": "229-524-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 2ND ST",
            "city": "DONALSONVILLE",
            "state": "GA",
            "postal_code": "398451601",
            "telephone_number": "229-524-5364",
            "fax_number": "229-524-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT AND MARY HARTZOG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A",
        "authorized_official_last_name": "HARTZOG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-524-2223",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1109227",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000035681A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "818850627B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seminole Hartzog Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seminole Hartzog Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roberts Pharmacy Inc (Roberts Pharmacy)
• Roberts Pharmacy Inc (Vital Care of Southwest Georgia, Donalsonville)
• Tekoa Meshawn Rogers, FNP
• Ronald E Harrell DDS PC
• Devin Lee Ross, FNP
• Seminole County Board of Education
• Seminole County Board of Health
• Seminole County Commisioner of Roads and Revenues (Seminole County EMS)
• Smith Counseling Clinic Inc
• Gary Wayne Smith, PHD

• Community/Retail Pharmacy in Donalsonville, GA
• Providers in Donalsonville, 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 Sep 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.