Crystal Pharmacy LLC

Crystal Pharmacy LLC is a healthcare organization registered as Pharmacist in Moultrie, GA, holding Type 2 (organization) NPI 1225116239 since 2006. The authorized official on file is Scotty Jarvis, Managing Member.

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NPI	1225116239
Entity type	Organization (Type 2)
Legal business name	Crystal Pharmacy LLC
Other name	<Unavail>
Practice address	705 SOUTH MAIN ST, Moultrie, GA, 31768
Phone	2299854137
Fax	2298905968
Enumeration date	2006-11-01
Last updated in NPPES	2023-03-07

Authorized official

Name	Scotty Jarvis
Title	Managing Member
Phone	2299854137

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
183500000X	Pharmacist	Primary	2206	GA

Other identifiers

Identifier	Type	State	Issuer
00025605A	Medicaid	GA	—
1101942	Other	—	NABP

Copy-ready billing details

Provider: Crystal Pharmacy LLC
NPI: 1225116239
Taxonomy: 183500000X (Pharmacist)
Address: 705 SOUTH MAIN ST, Moultrie, GA, 31768

Providers at this address

NPI	Name	Type	Specialty	Location
1649366550	Jeffrey Jarvis	Individual	Pharmacist	Moultrie, GA

Verify this record

Cross-check NPI 1225116239 against the authoritative CMS record: view Crystal Pharmacy LLC on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-03-07. Verify at npiregistry.cms.hhs.gov.

Where is Crystal Pharmacy LLC located?

The practice location on file with NPPES is in Moultrie, GA.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-03-07.