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PCCA INC NPI 1568473064


NPI Information

NPI: 1568473064
Provider Name: PCCA INC

Doing Business As: DUNWOODY PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D1078759

Address:
4675 N SHALLOWFORD RD
STE 101
DUNWOODY, GA
ZIP 30338
Phone: (770) 455-1144
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PCCA INC is a community/retail pharmacy pharmacy in Dunwoody, 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. PCCA INC NPI is 1568473064. The provider is registered as an organization entity type.
The provider Is Doing Business As Dunwoody Pharmacy.

The provider's business location address is:

4675 N SHALLOWFORD RD
STE 101
DUNWOODY, GA
ZIP 30338-309
Phone: (770) 455-1144
Fax: (770) 936-8989

The provider's authorized official is Charles Wilson .
The authorized official title is Owner Pharmacist and has the following contact phone number (770) 455-1144.

The CLIA number assigned to this NPI record is 11D1078759 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 6/8/2015.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy6006GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11188480001MEDICARE NSC
22015883OTHERPK
300655256AMEDICAIDGEORGIA

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: 5/5/2024

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