{"npi":"1891209615","type":"NPI-2","status":"active","name":{"display":"Family Wellness Pharmacy LLC","other":[],"organization_name":"FAMILY WELLNESS PHARMACY LLC","authorised_official":"Lam Le"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"3336S0011X","description":"Specialty Pharmacy","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"GA","license":"PHRE010414"}]},"addresses":[{"purpose":"LOCATION","street_1":"1630 PLEASANT HILL RD # C4","city":"DULUTH","state":"GA","postal_code":"300965899","country_code":"US","phone":"6787658476","fax":"6787658479"},{"purpose":"MAILING","street_1":"3118 PRESTWYCK HAVEN DR","city":"DULUTH","state":"GA","postal_code":"300974303","country_code":"US","phone":"6787658476","fax":"6787658479"}],"license":{"state":"GA","number":"PHRE010414"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"003199366A","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"003258370A","state":"GA","issuer":null},{"type_code":"01","label":"Other","value":"2174455","state":null,"issuer":"PK"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20180409002370","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"GA","pac_id":"2466715289"},{"enrlmt_id":"O20180817001976","type_code":"12-A5","type_desc":"PART B SUPPLIER - PHARMACY","state":"GA","pac_id":"2466715289"},{"enrlmt_id":"O20210825003045","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"AL","pac_id":"2466715289"}]},"enumeration_date":"2017-12-01","last_updated":"2025-09-03","_meta":{"source":"NPPES","snapshot_date":"2025-09-03","doc_url":"https://findmynpi.com/api"}}