COLBERT PHARMACY INC 127 4TH ST (NPI# 1164596680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164596680 |
| Entity Type | Organization |
| Organization Name | COLBERT PHARMACY INC 127 4TH ST |
| Other Organization Name | COLBERT PHARMACY |
| Practice Address |
5674 Highway 72 W Colbert GA 30628-2934 |
| Mailing Address |
Po Box 336 Colbert GA 30628-0336 |
| Practice Telephone | 7067882102 |
| Practice Fax Number | 7067889740 |
| Mailing Telephone | 7067882102 |
| Mailing Fax Number | 7067889470 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2011-06-07 |
| Authorized Official Name | WALTER WHITE (PRES) |
| Authorized Official Telephone | 7067882102 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE004838 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1102425 | 01 | |
| GA | 00025165A | 05 |
| Other Name | Type Code |
|---|---|
| COLBERT PHARMACY | Doing Business As Name - Organization |
| Street Address |
5674 HIGHWAY 72 W |
| City | COLBERT |
| State | GA |
| Zip Code | 30628-2934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326173956 | Jonathan Marc Perry | Pharmacist | 15 Colbert Business Parkway, Fred's Pharmacy #1394, Colbert, GA 30628 | 2007-02-22 |
| 1366938086 | Preston Gantt, Md, Sa-c | Surgery | 191 Valley Rd, Colbert, GA 30628 | 2018-07-05 |
| 1902304538 | Preston Gantt | Surgery | 191 Valley Rd, Colbert, GA 30628 | 2018-01-29 |
| 1972897700 | Akilah S Tomingas | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628 | 2011-06-09 |
| 1851680938 | Kelly Pascual Montgomery | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628 | 2011-03-29 |
| 1134559958 | Manuel Garcia-gaona | Physical Therapist | 19 Dogwood Dr, Colbert, GA 30628-1512 | 2013-11-14 |
| 1720353675 | Innovative Medical Group | Durable Medical Equipment & Medical Supplies | 232 Jeremy Dr, Colbert, GA 30628-1543 | 2012-03-11 |
| 1154399152 | Amanda Griffin Wagner | Psychologist | 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628-2445 | 2006-03-08 |
| 1588642771 | Nicole Ford | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2006-01-06 |
| 1477176600 | Dallas Louis | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2020-05-21 |
| Find all providers in zip 30628 | ||||
| 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] |
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| 1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
| 1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
| 1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
| 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.