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OLDE TIME PHARMACY AT SIXES, LLC
NPI 1912208539
Pharmacy - Community/Retail Pharmacy in Holly Springs, GA

Active since November 12, 2010
684 SIXES RD STE 105, HOLLY SPRINGS, GA 30115(770) 783-0483 Get Directions Write a Review

NPPES record last updated: December 1, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Olde Time Pharmacy At Sixes, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLDE TIME PHARMACY AT SIXES, LLC (NPI 1912208539) is a healthcare organization registered as a community/retail pharmacy in Holly Springs, Georgia and active in the NPI registry since November 2010. The organization lists Shad Sutherland, Owner, as its authorized official.

NPPES Registry Identity

NPI1912208539
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameOLDE TIME PHARMACY AT SIXES LLC
Location Address684 SIXES RD STE 105Holly Springs, GA 30115-8720
Mailing Address684 Sixes Rd, Suite 105Holly Springs, GA 30115-8721 · (770) 783-0483
Phone(770) 783-0483
Organization SubpartNo
Authorized OfficialShad SutherlandOwner · (770) 783-0483
Enumeration DateNovember 12, 2010
Last NPPES UpdateDecember 1, 2010
✔ NPI 1912208539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in GA · PHRE009711
Definition
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.
Also ListedPharmacyTaxonomy 333600000X
684 SIXES RD STE 105, Holly Springs, GA 30115
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Other Names 1

Doing Business AsOlde Time Pharmacy At Sixes, Llc

Other Identifiers 1

Other1160643Ncpdp Provider Identification Number

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DANIEL MCMAHON M.D.
Family Medicine
684 SIXES RD STE 105
HOLLY SPRINGS, GA 30115
Cherokee County (678) 388-5170
MIANNA MANTOOTH SMITH FNP-C
Nurse Practitioner (Family)
684 SIXES RD STE 105
HOLLY SPRINGS, GA 30115
Cherokee County (678) 388-5170
KENDALL WILLIAMS
Nurse Practitioner (Family)
684 SIXES RD STE 105
HOLLY SPRINGS, GA 30115
Cherokee County (678) 388-5170
DR. MONIKA S YADAV M.D.
Internal Medicine
684 SIXES RD STE 105
HOLLY SPRINGS, GA 30115
Cherokee County (678) 494-9669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olde Time Pharmacy At Sixes LLC's NPI number?

The NPI number for Olde Time Pharmacy At Sixes LLC is 1912208539. It was assigned to this organization in the NPPES registry on November 12, 2010. The provider is doing business as Olde Time Pharmacy At Sixes, LLC.

Where is Olde Time Pharmacy At Sixes LLC located?

Olde Time Pharmacy At Sixes LLC is located at 684 Sixes Rd Ste 105, Holly Springs, GA 30115. The listed phone number is (770) 783-0483.

What is Olde Time Pharmacy At Sixes LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Olde Time Pharmacy At Sixes LLC was last updated on December 1, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.