Locust Grove Family Medicine
Non-pharmacy Dispensing Site
3778 Highway 42, Locust Grove
Georgia, 30248-3632
678-610-6649 678-610-6025
Locust Grove Family Medicine is a Non-pharmacy Dispensing Site in Locust Grove, Georgia. It is located at 3778 Highway 42, Locust Grove and it's customer support contact number is 678-610-6649. The authorized person of Locust Grove Family Medicine is Dr. Nimisha J Trivedi, MD who is Owner of the pharmacy and his contact number is 678-610-6649. Active license number of Locust Grove Family Medicine is 053715 for Non-pharmacy Dispensing Site in Georgia. Locust Grove Family Medicine accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Locust Grove Family Medicine is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Pharmacy Details:
Locust Grove Family Medicine type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Locust Grove Family Medicine |
| Type: | Non-pharmacy Dispensing Site |
| Location: | 3778 Highway 42, Locust Grove,
Georgia, 30248-3632 |
| Phone: | 678-610-6649 |
| Fax: | 678-610-6025 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Nimisha J Trivedi |
| Credentials: | MD |
| Position: | Owner |
| Contact Number: | 678-610-6649 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1629169164 |
| NPI Enumeration Date: | 28 Sep, 2006 |
| NPI Last Update On: | 14 Mar, 2016 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Locust Grove Family Medicine are as mentioned below.
| Specialization | License Number | State | Status | |
| Non-pharmacy Dispensing Site | 053715 | Georgia | Primary | |
| Family Medicine | 053715 | Georgia | Secondary | |
Medicare Enrollment:
Locust Grove Family Medicine is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 1052306008 | O20040419000601 | Locust Grove Family Medicine | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 3778 Highway 42,
Locust Grove, Georgia |
| Zip: | 30248-3632 |
| Phone Number: | 678-610-6649 |
| Fax Number: | 678-610-6025 |
Patients can reach Locust Grove Family Medicine at
3778 Highway 42, Locust Grove, Georgia or can
call on customer care at 678-610-6649.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.