GEORGIA STATE PRISON REGIONAL PHARMACY (NPI# 1184115321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184115321 |
| Entity Type | Organization |
| Organization Name | GEORGIA STATE PRISON REGIONAL PHARMACY |
| Practice Address |
300 1st Ave S Reidsville GA 30453-9304 |
| Practice Telephone | 9125577960 |
| Practice Fax Number | 9125577975 |
| Mailing Telephone | 9125577960 |
| Mailing Fax Number | 9125577975 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | MR. BENJAMIN CLARK (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 9125577960 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA DEPARTMENT OF CORRECTIONS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
PHH005792 | GA | Suppliers |
| Street Address |
300 1ST AVE S |
| City | REIDSVILLE |
| State | GA |
| Zip Code | 30453-9304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285856088 | James A Ray | Dentist | 300 1st Ave S, Reidsville, GA 30453-9304 | 2007-05-02 |
| 1538684592 | Melissa Gail Clark | Family Medicine | 300 1st Ave S, Reidsville, GA 30453-9304 | 2017-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659990869 | Katrina A Toler | Specialist/Technologist, Other | Optim Medical Center - Tattnall, 247 S Main Street, Reidsville, GA 30453 | 2020-04-09 |
| 1548750110 | Benjamin Addril Clark | Pharmacist | Se Regional Pharmacy Attn: Ben Clark, 300 First Avenue South, Reidsville, GA 30453 | 2018-05-18 |
| 1770824351 | Elite Care Dme,llc | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2013-03-07 |
| 1003154766 | Rebekah Hollis Parker | Occupational Therapist | 247 A South Main Street, Reidsville, GA 30453 | 2013-01-30 |
| 1629359419 | D. Wilson Inc. | Durable Medical Equipment & Medical Supplies | 121 South Main Street Unit A, Reidsville, GA 30453 | 2011-09-07 |
| 1417278029 | Tattnall Community Ems | Ambulance | 194 John O Parker Dr., Reidsville, GA 30453 | 2010-06-17 |
| 1518122563 | Brenda Marie Black | Licensed Practical Nurse | 150 Memorial Drive, 150 Memorial Drive, Reidsville, GA 30453 | 2008-07-18 |
| 1063694404 | Ihori Kameyama | Counselor | 150 Memorial Dr., Reidsville, GA 30453 | 2007-11-28 |
| 1710947403 | Donald Franklin Kennedy Jr. | Specialist | 131 Memorial Drive, Reidsville, GA 30453 | 2006-03-25 |
| 1801438676 | Olive Care Durable Medical & Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2019-10-14 |
| Find all providers in zip 30453 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; 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 |
|---|---|---|---|---|
| 1932690922 | Middle Georgia Correctional Complex Pharmacy | Pharmacy | 2271 Vinson Hwy Se, Milledgeville, GA 31061-4807 | 2018-05-24 |
| 1316438393 | Macon State Prison Regional Pharmacy | Pharmacy | 2728 Ga Highway 49 S, Oglethorpe, GA 31068-8129 | 2018-05-24 |
| 1851882013 | Lee Arrendale State Prison Pharmacy | Pharmacy | 2023a Gainesville Hwy, Alto, GA 30510-4435 | 2018-05-23 |
| 1831689728 | Autry State Prison Pharmacy | Pharmacy | 3178 Mount Zion Church Rd, Pelham, GA 31779 | 2018-05-16 |
| 1003939794 | Nw Ga Regional Hospital | Pharmacy | 705 N Division St Nw, Rome, GA 30165-1454 | 2007-04-09 |
| 1861505430 | Department of Behavioral Health and Developmental Disabilities | Pharmacy | 325 Lawrence Rd, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-16 |
| 1689165482 | Georgia Diagnostic & Classification Prison Pharmacy | Pharmacy | 2978 Highway 36 W, Jackson, GA 30233-6150 | 2018-05-29 |
| 1902397995 | Pulaski State Prison Regional Pharmacy | Pharmacy | 373 Upper River Rd, Hawkinsville, GA 31036-8898 | 2018-05-24 |
| 1972094134 | Valdosta State Prison Regional Pharmacy | Pharmacy | 3259 Val Tech Rd, Valdosta, GA 31602-9309 | 2018-05-23 |
| 1902397151 | Augusta State Medical Prison | Pharmacy | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2018-05-23 |
| Find all providers with the same taxonomy | ||||
| City | REIDSVILLE |
| Zip Code | 30453 |
Please comment or provide details below to improve the information on GEORGIA STATE PRISON REGIONAL PHARMACY.
| 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.