CTCA RX, LLC (NPI# 1093211005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093211005 |
| Entity Type | Organization |
| Organization Name | CTCA RX, LLC |
| Other Organization Name | CTCA/RX |
| Practice Address |
610 Celebrate Life Pkwy Newnan GA 30265-8001 |
| Mailing Address |
1620 W Northwest Hwy Suite 100 Grapevine TX 76051-3119 |
| Practice Telephone | 6785522013 |
| Practice Fax Number | 8177201039 |
| Mailing Telephone | 8175720009 |
| Mailing Fax Number | 8177201039 |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |
| Authorized Official Name | TAMMIE MISKIMINS (SENIOR MANAGER) |
| Authorized Official Telephone | 8175720009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010615 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2176770 | 01 |
| Other Name | Type Code |
|---|---|
| CTCA/Rx | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CTCA RX, LLC | 610 Celebrate Life Pkwy, Newnan, GA 30265 |
| Street Address |
610 CELEBRATE LIFE PKWY |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265-8001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1356823363 | Stephen William Jacon | Specialist/Technologist | 29 Muirfield Court, Newnan, GA 30265 | 2018-09-05 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| Find all providers in zip 30265 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396383444 | Senoia Drug Co Inc. | Pharmacy | 2080 Newnan Crossing Blvd E Ste 100, Newnan, GA 30265-2558 | 2019-12-18 |
| 1710492137 | Bhumika Patel | Pharmacy | 101a Greison Trl, Newnan, GA 30263-1442 | 2017-12-07 |
| 1760534010 | Thompson's Pharmacy, Inc. | Pharmacy | 134 Millard Farmer Industrial Blvd, Newnan, GA 30263 | 2007-01-17 |
| 1447357934 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 2305 Hwy 34 East, Newnan, GA 30265 | 2006-09-19 |
| 1245333087 | Georgia Cvs Pharmacy LLC | Pharmacy | 239 Temple Ave, Newnan, GA 30263-1368 | 2006-09-07 |
| 1295779577 | Walgreen Co | Pharmacy | 1 Farmer Industrial Blvd, Newnan, GA 30263-1078 | 2006-06-16 |
| 1083213904 | Jin Hyuk Seo | Pharmacy | 1751 Newnan Crossing Blvd E, Newnan, GA 30265-1517 | 2020-10-21 |
| 1073143202 | Tarpley Drug Company | Pharmacy | 40 Hospital Rd, Newnan, GA 30263-1201 | 2020-01-15 |
| 1609412584 | Leech Pharmacy, LLC | Pharmacy | 18 Cavender St, Newnan, GA 30263-1932 | 2019-11-26 |
| 1730602343 | Walgreen Co | Pharmacy | 3055 Highway 34 E, Newnan, GA 30265-2179 | 2017-07-25 |
| Find all providers in NEWNAN | ||||
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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.