OrganizationActive
Crystal Pharmacy LLC
NPI 1790877942 · Community/Retail Pharmacy · Moultrie, GA
Crystal Pharmacy LLC is a Community/Retail Pharmacy organization in Moultrie, GA (NPI 1790877942).
Provider details
- NPI number
- 1790877942
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Scotty Jarvis, Managing Member(229) 985-4137
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
705 S Main St
Moultrie, GA 31768-5432
Phone: (229) 985-4137
Fax: (229) 890-5968
Street-level locationGet directions
Mailing address
Po Box 8
Moultrie, GA 31776-0008
Other names (DBA / former)
- Doing business as
- Crystal Pharmacy
Registry dates
- Enumerated
- 2006-09-28
- Last updated
- 2014-11-25
Frequently asked questions
- What is Crystal Pharmacy LLC's NPI number?
- Crystal Pharmacy LLC's National Provider Identifier (NPI) is 1790877942, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crystal Pharmacy LLC?
- Crystal Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Crystal Pharmacy LLC located?
- Crystal Pharmacy LLC's practice location on file with NPPES is 705 S Main St, Moultrie, GA 31768-5432.
- What is Crystal Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Crystal Pharmacy LLC is (229) 985-4137.
- Who is the authorized official for Crystal Pharmacy LLC?
- The authorized official listed on Crystal Pharmacy LLC's NPPES record is Scotty Jarvis, Managing Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crystal Pharmacy LLC's NPI active?
- Yes — Crystal Pharmacy LLC's NPI (1790877942) is active in the NPPES registry as of the last update on 2014-11-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.