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MIRROR LAKE DRUGS & MEDICAL SERVICES LLC
NPI 1962755256
Pharmacy - Community/Retail Pharmacy in Villa Rica, GA

Active since October 24, 2012
895 DALLAS HWY, VILLA RICA, GA 30180(770) 462-1152(770) 462-1154 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 22, 2020, Jul 19, 2018, Apr 18, 2018 and 1 more (4 updates tracked since 2017).

About Mirror Lake Drugs & Medical Services Llc NPPES

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

MIRROR LAKE DRUGS & MEDICAL SERVICES LLC (NPI 1962755256), doing business as Rockmart Pharmacy & Medical Services Llc, is a healthcare organization registered as a community/retail pharmacy in Villa Rica, Georgia and active in the NPI registry since October 2012. The organization lists Chymar Okorie Ihekwereme, Pic/chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1962755256
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMIRROR LAKE DRUGS & MEDICAL SERVICES LLC
Location Address895 DALLAS HWYVilla Rica, GA 30180-1237
Mailing Address895 Dallas HwyVilla Rica, GA 30180-1237 · (770) 462-1152 · Fax (770) 462-1154
Phone(770) 462-1152
Fax(770) 462-1154
Organization SubpartNo
Authorized OfficialChymar Okorie IhekweremePic/chief Executive Officer · (770) 462-1152
Enumeration DateOctober 24, 2012
Last NPPES UpdateOctober 22, 20204 updates tracked since enumeration
NPPES CertifiedOctober 22, 2020
✔ NPI 1962755256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in GA · PHRE009876
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 ListedPharmacistTaxonomy 183500000X
Also ListedPharmacyTaxonomy 333600000X
895 DALLAS HWY, Villa Rica, GA 30180
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Other Names 1

Former Legal Business NameRockmart Pharmacy & Medical Services Llc

Other Identifiers 2

Other2137507Pk
Medicaid003129213AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Other Providers at the Same Location NPPES

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

MIRROR LAKE DRUGS & MEDICAL SERVICES LLC
Pharmacy (Community/Retail Pharmacy)
895 DALLAS HWY
VILLA RICA, GA 30180
Carroll County (770) 462-1152

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 Mirror Lake Drugs & Medical Services LLC's NPI number?

The NPI number for Mirror Lake Drugs & Medical Services LLC is 1962755256. It was assigned to this organization in the NPPES registry on October 24, 2012. The provider was formerly known as Rockmart Pharmacy & Medical Services LLC.

Where is Mirror Lake Drugs & Medical Services LLC located?

Mirror Lake Drugs & Medical Services LLC is located at 895 Dallas Hwy, Villa Rica, GA 30180. The listed phone number is (770) 462-1152.

What is Mirror Lake Drugs & Medical Services LLC's specialty?

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

What insurance does Mirror Lake Drugs & Medical Services LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 46 other insurers list Mirror Lake Drugs & Medical Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mirror Lake Drugs & Medical Services LLC was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.