MIMBS DRUG CO DBA DIXIE CITY PHARMACY # 2 (NPI# 1467439760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467439760 |
| Entity Type | Organization |
| Organization Name | MIMBS DRUG CO DBA DIXIE CITY PHARMACY # 2 |
| Other Organization Name | DIXIE CITY PHARMACY # 2 |
| Practice Address |
4222 Mcever Rd Oakwood GA 30566-2237 |
| Practice Telephone | 7705361099 |
| Practice Fax Number | 7705360577 |
| Mailing Telephone | 7705361099 |
| Mailing Fax Number | 7705360577 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. EDDIE H MIMBS (PRESIDENT) |
| Authorized Official Telephone | 7705363329 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | PHRE006004 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00247937A | 05 | |
| GA | DEA NUMBER | AD1768095 | 01 |
| GA | NCPDP NUMBER | 1126867 | 01 |
| GA | STATE LISC # | PHRE006004 | 01 |
| Other Name | Type Code |
|---|---|
| Dixie City Pharmacy # 2 | Doing Business As Name - Organization |
| Street Address |
4222 MCEVER RD |
| City | OAKWOOD |
| State | GA |
| Zip Code | 30566-2237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184770968 | Patricia Ann Cox | Pharmacist | 4222 Mcever Rd, Oakwood, GA 30566-2237 | 2007-01-26 |
| 1285780650 | Maria Luz Chavez | Pharmacy Technician | 4222 Mcever Rd, Oakwood, GA 30566-2237 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811480676 | Travis Core | Physical Therapist | 4220 Mundy Mill Pl Ste 2b, Oakwood, GA 30566 | 2018-06-07 |
| 1174922751 | Luke Lenahan | Physician Assistant | 3931 Mundy Mill Rd., Ste B, Oakwood, GA 30566 | 2014-08-19 |
| 1144584384 | Stephanie Mccullum | Occupational Therapist | 1006 Creeekside Place, Oakwood, GA 30566 | 2012-07-03 |
| 1528357951 | Extended Care Center of Oakwood LLC | Family Medicine | 4205 Mundy Mill Pl., Suite 1, Oakwood, GA 30566 | 2011-04-06 |
| 1265673305 | Patti P Shipp | Counselor | 4347 Mundy Mill Rd Ste A2, Oakwood, GA 30566 | 2009-03-19 |
| 1124281217 | Ionut Radu | Optometrist | 3839 Mundy Mills Road, Oakwood, GA 30566 | 2008-07-08 |
| 1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
| 1851423057 | Oakwood Medical Clinic | Clinic/Center | 3626 Old Oakwood Rd, Oakwood, GA 30566 | 2007-03-12 |
| 1386619526 | Robert O Kelly | Family Medicine | 3931 Mundy Mill Rd., Oakwood, GA 30566 | 2006-02-21 |
| 1003464538 | Nichole Abernathy Hasan | Pharmacist | Walmart Pharmacy, 3827 Mundy Mill Rd, Oakwood, GA 30566 | 2019-08-28 |
| Find all providers in zip 30566 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316229883 | Appalachian College of Pharmacy | Pharmacy | 8252 Riverside Dr, Oakwood, VA 24631-8972 | 2011-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607662 | H & W Pharmacy | Pharmacy | 4091 Redan Rd Ste C, Stone Mountain, GA 30083-4767 | 2020-10-23 |
| 1720603756 | Medical-pharmacy Associates of Georgia, LLC | Pharmacy | 1425 Georgia Ave Ste 1, Macon, GA 31201-6546 | 2020-06-16 |
| 1700419454 | Janus Rx | Pharmacy | 836 E 65th St Ste 42, Savannah, GA 31405-4496 | 2020-02-20 |
| 1295373702 | Downtown Pharmacy LLC | Pharmacy | 236 Forsyth St Sw Ste 202b, Atlanta, GA 30303-3786 | 2019-12-16 |
| 1750928719 | Goodscript, Inc. | Pharmacy | 3115 Roswell Rd Ste 205, Marietta, GA 30062-7611 | 2019-12-09 |
| 1942844741 | Genoa Healthcare, LLC | Pharmacy | 400 Technology Ct Se Ste J, Room P, Smyrna, GA 30082-5237 | 2019-11-05 |
| 1225670995 | Allcare Pharmacy, LLC | Pharmacy | 1004 S Tennille Ave, Donalsonville, GA 39845 | 2019-10-14 |
| 1417598327 | Connect Care Pharmacy, LLC | Pharmacy | 2191 Hwy 247 Connector, Byron, GA 31008-5531 | 2019-10-02 |
| 1467003467 | Selamawit Dejene | Pharmacy | 464 Bishop St Nw Apt 336, Atlanta, GA 30318-5384 | 2019-09-23 |
| 1902454721 | Batts Drug Company Mansfield, LLC | Pharmacy | 4424 Highway 213, Mansfield, GA 30055-3211 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
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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.