LEE GOODRUM PHARMACY
NPI 1053332015
Pharmacy - Community/Retail Pharmacy in Newnan, GA

NPI Status: Active since July 22, 2006

Contact Information

40 HOSPITAL RD
NEWNAN, GA
ZIP 30263
Phone: (770) 253-1121
Fax: (770) 253-3572

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • CLIA Number: 11D2187360
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 06-30-2026

About LEE GOODRUM PHARMACY

This page provides the complete NPI Profile along with additional information for Lee Goodrum Pharmacy, a provider established in Newnan, Georgia operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1053332015 assigned on July 2006. The practitioner's primary taxonomy code is 3336C0003X with license number PHRE006304 (GA). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Lee Goodrum Pharmacy. The authorized official of this NPI record is John Goodrum Bs Pharmacy (Ceo)

NPI
1053332015
Provider Legal Name
LEE GOODRUM PHARMACY INC
Other Organization Name
LEE GOODRUM PHARMACY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
40 HOSPITAL RD NEWNAN, GA 30263
Location Phone
(770) 253-1121
Location Fax
(770) 253-3572
Mailing Address
40 HOSPITAL RD NEWNAN, GA 30263
Mailing Phone
(770) 253-1121
Mailing Fax
(770) 253-3572
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-22-2006
Last Update Date
04-25-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
PHRE006304
License State
GA
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1333600000XSuppliers

Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOHN GOODRUM BS PHARMACY

Authorized Official Title
CEO
Authorized Official Phone
(770) 253-1121

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2014853OTHER (01)PK
0975740001MEDICARE NSC (07) 
00285051AMEDICAID (05)GA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D2187360
Facility Type
Pharmacy
Certificate Effective Date
July 01, 2024
Certificate Expiration Date
June 30, 2026
Laboratory Director
CASEY A. TARPLEY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lee Goodrum Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for LEE GOODRUM PHARMACY

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053332015, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
3
Doubled → 6
Pos 6
3
Unchanged
Pos 7
2
Doubled → 4
Pos 8
0
Unchanged
Pos 9
1
Doubled → 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 3 → 6 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 6 + 3 + 4 + 0 + 2 + 24 = 45

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 45 is 50. The difference is the calculated check digit.

50 - 45 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1053332015.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Pharmacist
40 HOSPITAL RD
NEWNAN, GA 30263
Pharmacist
40 HOSPITAL RD
NEWNAN, GA 30263
Pharmacy (Community/Retail Pharmacy)
40 HOSPITAL RD
NEWNAN, GA 30263
Pharmacy (Long Term Care Pharmacy)
40 HOSPITAL RD
NEWNAN, GA 30263
Pharmacist
40 HOSPITAL RD
NEWNAN, GA 30263

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053332015, enumerated as an "organization" on July 22, 2006.

The provider is located at 40 HOSPITAL RD NEWNAN, GA 30263 and the phone number is (770) 253-1121.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.