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MORTAR & PESTLE LLC NPI 1629418793


NPI Information

NPI: 1629418793
Provider Name: MORTAR & PESTLE, LLC

Doing Business As: THE MEDICINE CABINET

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D2108729

Address:
205 VERNON STREET
LAGRANGE, GA
ZIP 30240
Phone: (706) 298-4928
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MORTAR & PESTLE, LLC is a community/retail pharmacy pharmacy in Lagrange, 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. MORTAR & PESTLE, LLC NPI is 1629418793. The provider is registered as an organization entity type.
The provider Is Doing Business As The Medicine Cabinet.

The provider's business location address is:

205 VERNON STREET
LAGRANGE, GA
ZIP 30240
Phone: (706) 298-4928
Fax: (706) 298-4929

The provider's authorized official is Jon Meeks .
The authorized official title is Owner/pharmacist and has the following contact phone number (912) 383-8510.

The CLIA number assigned to this NPI record is 11D2108729 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/3/2013 and was last updated on 7/15/2020.


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 PharmacyPHRE009938GEORGIAYes

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
1003136178AMEDICAIDGEORGIA
22141011OTHERPK

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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