SOUTHERN PAIN INSTITUTE P C (NPI# 1174836845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174836845 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PAIN INSTITUTE P C |
| Other Organization Name | SOUTHERN PAIN INSTITUTE |
| Practice Address |
1501 Milstead Rd Ne Ste 140 Conyers GA 30012-3849 |
| Mailing Address |
1975 Highway 54 W Ste 100 Peachtree City GA 30269-4794 |
| Practice Telephone | 7706323730 |
| Practice Fax Number | 7706323731 |
| Mailing Telephone | 7703133380 |
| Mailing Fax Number | 7706323731 |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2015-02-24 |
| Authorized Official Name | LYNN CLAVO (PIC) |
| Authorized Official Telephone | 7706323730 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE009658 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003100329A | 05 | |
| PK | 2125516 | 01 |
| Other Name | Type Code |
|---|---|
| Southern Pain Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750665584 | Southern Pain Institute P C | Pharmacy | 1975 Highway 54 W Ste 100, Fayetteville, GA 30214-4794 | 2011-09-28 |
| Street Address |
1501 MILSTEAD RD NE STE 140 |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| 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 |
|---|---|---|---|---|
| 1730739426 | Eagle Rx LLC | Pharmacy | 1029 Honey Creek Rd Se, Conyers, GA 30013-2948 | 2019-09-16 |
| 1023673746 | Nir-mal Ventures, Inc | Pharmacy | 2020 Eastside Dr Ste 206, Conyers, GA 30013-1955 | 2019-05-08 |
| 1669831012 | Shreeji Pharmacy LLC | Pharmacy | 405 Sigman Rd Nw Ste B, Conyers, GA 30012-3625 | 2016-02-14 |
| 1013041722 | Beasley Drug Company | Pharmacy | 933 Center St Ne, Conyers, GA 30012-4567 | 2007-03-15 |
| 1669554804 | Georgia Cvs Pharmacy LLC | Pharmacy | 2195 Highway 20 Se, Conyers, GA 30013-2028 | 2006-10-19 |
| 1982707717 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 3481 Highway 20 Se, Conyers, GA 30013-2862 | 2006-09-07 |
| 1801999651 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 1541 Georgia Highway 20 Ne, Conyers, GA 30012-3834 | 2006-09-07 |
| 1073521845 | Cowan Pharmacy LLC | Pharmacy | 1179 West Ave Sw, Conyers, GA 30012-5280 | 2006-08-04 |
| 1558875294 | Cowan Pharmacy LLC | Pharmacy | 1179 West Ave Sw, Conyers, GA 30012-5280 | 2017-11-16 |
| 1275056871 | Walgreen Co | Pharmacy | 3531 Highway 20 Se Ste A, Conyers, GA 30013-2804 | 2017-07-25 |
| Find all providers in CONYERS | ||||
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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.