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LONGS DRUGS OF SANDERSVILLE GEORGIA INC NPI 1053357509


NPI Information

NPI: 1053357509
Provider Name: LONGS DRUGS OF SANDERSVILLE GEORGIA INC

Doing Business As: AVITA PHARMACY 1046

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
2140 PEACHTREE RD NW
SUITE 232
ATLANTA, GA
ZIP 30309
Phone: (404) 231-4431
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LONGS DRUGS OF SANDERSVILLE GEORGIA INC is a community/retail pharmacy pharmacy in Atlanta, GA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. LONGS DRUGS OF SANDERSVILLE GEORGIA INC NPI is 1053357509. The provider is registered as an organization entity type.
The provider Is Doing Business As Avita Pharmacy 1046.

The provider's business location address is:

2140 PEACHTREE RD NW
SUITE 232
ATLANTA, GA
ZIP 30309-316
Phone: (404) 231-4431
Fax: (404) 231-5677

The provider's authorized official is Carl Cody Colquitt .
The authorized official title is Chief Financial Officer and has the following contact phone number (469) 592-2011.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 12/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0002XPharmacyClinic PharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyPHRE009702GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11148279OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2003291812AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.