MEDEQUIP HEALTH CORP (NPI# 1063669315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063669315 |
| Entity Type | Organization |
| Organization Name | MEDEQUIP HEALTH CORP |
| Other Organization Name | MEDICAL CENTER WEST COMPDING LAB |
| Practice Address |
465 N Belair Rd 1a2 Evans GA 30809-3188 |
| Mailing Address |
465 N Belair Rd Ste 1a2 Evans GA 30809-3188 |
| Practice Telephone | 7068555502 |
| Practice Fax Number | 7068542425 |
| Mailing Telephone | 7068555502 |
| Mailing Fax Number | 7068542425 |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |
| Authorized Official Name | KYLE W PULLIAM (PHARMACIST) |
| Authorized Official Telephone | 7068555502 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHRE009484 | GA | Suppliers |
| Other Name | Type Code |
|---|---|
| MEDICAL CENTER WEST COMPDING LAB | Doing Business As Name - Organization |
| Street Address |
465 N BELAIR RD 1A2 |
| City | EVANS |
| State | GA |
| Zip Code | 30809-3188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790784593 | Stephen Lewis Schmidt | Family Medicine | 465 N Belair Rd, Suite 1c, Evans, GA 30809-3188 | 2005-07-14 |
| 1689145781 | Ashli D Thomas | Internal Medicine | 465 N Belair Rd, Evans, GA 30809-3188 | 2018-12-16 |
| 1265885883 | Clint Lanier Holton | Nurse Practitioner | 465 N Belair Rd, Suite 1b, Evans, GA 30809-3188 | 2016-07-19 |
| 1033450820 | Kathryn Ricks Toburen | Nurse Practitioner | 465 N Belair Rd, Suite 1-b, Evans, GA 30809-3188 | 2013-03-05 |
| 1396010427 | Bethany Joy Rudge Gilley | Physician Assistant | 465 N Belair Rd, Suite 1 B, Evans, GA 30809-3188 | 2012-03-22 |
| 1386924157 | Katie Nelson, Lpc, LLC | Counselor | 465 N Belair Rd, Ste 2d, Evans, GA 30809-3188 | 2011-08-24 |
| 1154628451 | Wellpull Corporation of Evans | Durable Medical Equipment & Medical Supplies | 465 N Belair Rd, Suite 1a, Evans, GA 30809-3188 | 2011-02-22 |
| 1023229887 | Margo Louise Henderson | Nurse Practitioner | 465 N Belair Rd, Ste 2b, Evans, GA 30809-3190 | 2007-05-24 |
| 1457565004 | Christopher Patrick Parker | Pharmacist | 465 N Belair Rd, Suite 1a, Evans, GA 30809-3188 | 2007-05-10 |
| 1871718908 | Maria Alicia Johnson | Family Medicine | 465 N Belair Rd, Suite 1b, Evans, GA 30809-3188 | 2007-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674060 | Dominion Behavioral Health Services LLC | Psychiatric Unit | 817 Prairie Lane, Evans, GEORGIA 30809 | 2020-03-13 |
| 1710478102 | Georgia Dental Professionals, PC | Dentist | 5131 Washington Rd, Evans, GA 30809 | 2018-05-22 |
| 1649770678 | Angel Legare | Physician Assistant | 404 Town Park Blvd Ste 101, Evans, GA 30809 | 2018-02-16 |
| 1952829541 | Felicia Evette Rhodes | Home Health Aide | 715 Jones Creek, Evans, GA 30809 | 2017-09-02 |
| 1659733582 | Patricia J. Stewart Lpc, LLC | Counselor | 465 N. Belair Rd. Ste 2d, Evans, GA 30809 | 2016-03-21 |
| 1114306727 | John Mccaskey | Family Medicine | 465 N Belair Rd Ste 1b, Evans, GA 30809 | 2015-05-28 |
| 1053702878 | Jennifer Wahl | Assistant Behavior Analyst | 1135 Waltons Pass, Evans, GA 30809 | 2015-02-16 |
| 1609298777 | Custom Pharmacy, Inc | Pharmacy | 1202 Town Park Lane, Suite 200, Evans, GA 30809 | 2014-01-09 |
| 1457797938 | Perfect Health Always On Call, LLC | Non-Pharmacy Dispensing Site | 4244 Washington Rd, Evans, GA 30809 | 2013-05-11 |
| 1417207119 | Tommy Battle | Respiratory Therapist, Registered | 101 Pond View, Evans, GA 30809 | 2012-09-11 |
| Find all providers in zip 30809 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204921 | P2 Pharmaceutical Services, LLC | Pharmacy | 2744 Broad St, Austell, GA 30106-3200 | 2020-10-28 |
| 1326654179 | Hawthorne Compounding Pharmacy LLC | Pharmacy | 100 Hawthorne Ln Ste A, Athens, GA 30606-2171 | 2020-09-17 |
| 1730710914 | Servemed, Inc | Pharmacy | 10263 Us Hwy 19, Suite 226, 226 Plaza Drive, Zebulon, GA 30295 | 2020-01-28 |
| 1013471010 | Kennison Pharmacy, LLC | Pharmacy | 4050 Buford Drive, Buford, GA 30518 | 2019-01-24 |
| 1629563317 | Dalton Worx, LLC | Pharmacy | 1506 N Thornton Ave Ste A, Dalton, GA 30720-8515 | 2018-06-26 |
| 1285145789 | Express At Northside LLC | Pharmacy | 296 Northside Dr Sw, Atlanta, GA 30313-1228 | 2017-10-24 |
| 1619411394 | Rita Rx Inc | Pharmacy | 3379 Highway 5 Ste F, Douglasville, GA 30135-2377 | 2016-12-14 |
| 1942756176 | Med-4-you LLC | Pharmacy | 3970 Peachtree Industrial Blvd, Berkeley Lake, GA 30096-4809 | 2016-08-28 |
| 1245785120 | Lambert Pharmacy LLC | Pharmacy | 15 Thomas Grace Annex Ln Ste 150, Sharpsburg, GA 30277-3653 | 2016-08-19 |
| 1629438296 | Express Drugs of Savannah LLC | Pharmacy | 824 E De Renne Ave, Savannah, GA 31405-6717 | 2016-02-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.