CHICKAMAUGA DRUG STORE, LLC (NPI# 1821131996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821131996 |
| Entity Type | Organization |
| Organization Name | CHICKAMAUGA DRUG STORE, LLC |
| Practice Address |
114 Cove Rd Chickamauga GA 30707-1407 |
| Practice Telephone | 7063752611 |
| Practice Fax Number | 7063756219 |
| Mailing Telephone | 7063752611 |
| Mailing Fax Number | 7063756219 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2010-08-13 |
| Authorized Official Name | PHILLIP TALLEY (CHIEF MANAGER) |
| Authorized Official Telephone | 7063752611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE005365 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00024582A | 05 |
| Street Address |
114 COVE RD |
| City | CHICKAMAUGA |
| State | GA |
| Zip Code | 30707-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831261387 | Phillip David Talley | Pharmacist | 114 Cove Rd, Chickamauga, GA 30707-1407 | 2006-11-13 |
| 1760606966 | Karen Leanne Ledford | Pharmacist | 114 Cove Rd, Chickamauga, GA 30707-1407 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881677847 | Paul E Ballinger | Physician Assistant | 101 Kington Lane, Chickamauga, GA 30707 | 2005-11-23 |
| 1235358938 | Tawanda G Adeshina | Family Medicine | 101 Kington Lane, Chickamauga, GA 30707 | 2007-04-24 |
| 1053638874 | Jerry Labron Ragon | Contractor | 8 W 8th St, Chickamauga, GA 30707-1308 | 2010-05-04 |
| 1073548707 | Douglas M Graydon | Dentist | 107 Gordon St, Chickamauga, GA 30707-1454 | 2006-07-11 |
| 1245372101 | Caroline Faith Brown | Dentist | 107 Gordon St, Chickamauga, GA 30707-1454 | 2007-02-13 |
| 1417483850 | Teresa Cash | Community/Behavioral Health | 16 Euclid Ave, Apt S-2, Chickamauga, GA 30707-1565 | 2017-05-04 |
| 1033416623 | Chickamauga City Schools | Local Education Agency (LEA) | 402 Cove Rd, Chickamauga, GA 30707-1614 | 2011-02-17 |
| 1992751747 | Hutcheson Primary Care, LLC | Family Medicine | 230 Lafayette Rd, Chickamauga, GA 30707-1707 | 2006-05-25 |
| 1013435338 | Cannon Drugs Ltd | Pharmacy | 357 Lee and Gordon Mill Rd, Chickamauga, GA 30707-1716 | 2017-09-07 |
| 1780028258 | Janis C Lewis | Counselor | 662 Grand Center Rd, Chickamauga, GA 30707-1854 | 2013-04-26 |
| Find all providers in zip 30707 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013435338 | Cannon Drugs Ltd | Pharmacy | 357 Lee and Gordon Mill Rd, Chickamauga, GA 30707-1716 | 2017-09-07 |
| 1396176095 | Freds Stores of Tennessee Inc | Pharmacy | 93 Bushrod Johnson Ave, Chickamauga, GA 30707-6093 | 2013-12-05 |
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| Find all providers with the same taxonomy | ||||
| City | CHICKAMAUGA |
| Zip Code | 30707 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.