DEKALB COMMUNITY SERVICE BOARD (NPI# 1205838679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205838679 |
| Entity Type | Organization |
| Organization Name | DEKALB COMMUNITY SERVICE BOARD |
| Other Organization Name | KIRKWOOD MHC PHARMACY |
| Practice Address |
23 Warren St Se Atlanta GA 30317-2201 |
| Practice Telephone | 4043707476 |
| Mailing Telephone | 4043707476 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2007-07-09 |
| Authorized Official Name | GARY S RICHEY (DIRECTOR) |
| Authorized Official Telephone | 4042943836 |
| Authorized Official Credential | MBA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 008190 | GA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | NCPDP/NABP PROVIDER # | 1119038 | 01 |
| GA | 00611212A | 05 |
| Other Name | Type Code |
|---|---|
| Kirkwood MHC Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750426755 | Dekalb Community Service Board | Community/Behavioral Health | 2129 Luray Ct, Dunwoody, GA 30338-5212 | 2007-02-20 |
| 1548304637 | Dekalb Community Service Board | Community/Behavioral Health | 4781 Lewis Rd, Stone Mountain, GA 30083-1020 | 2007-02-20 |
| 1932244993 | Dekalb Community Service Board | Community/Behavioral Health | 1116 Alford Rd, Lithonia, GA 30058-6094 | 2007-02-20 |
| 1154466142 | Dekalb Community Service Board | Community/Behavioral Health | 3571 Embry Cir, Chamblee, GA 30341-5613 | 2007-02-20 |
| 1629113436 | Dekalb Community Service Board | Community/Behavioral Health | 4559 Lavista Rd, Tucker, GA 30084-4225 | 2007-02-20 |
| 1497890214 | Dekalb Community Service Board | Community/Behavioral Health | 4200 Waterloo Cir, Tucker, GA 30084-2237 | 2007-02-20 |
| 1861536955 | Dekalb Community Service Board | Community/Behavioral Health | 2660 Osborne Rd Ne, Atlanta, GA 30319-2832 | 2007-02-20 |
| 1003951088 | Dekalb Community Service Board | Community/Behavioral Health | 4316 Smithsonia Dr, Tucker, GA 30084-2615 | 2007-02-20 |
| 1427193226 | Dekalb Community Service Board | Community/Behavioral Health | 1536 Saint Dunstans Rd, Lithonia, GA 30058-5632 | 2007-02-20 |
| 1528103512 | Dekalb Community Service Board | Community/Behavioral Health | 3807 Clairmont Road Ne, Chamblee, GA 30341 | 2007-02-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEKALB COMMUNITY SERVICE BOARD | 445 Winn Way, Decatur, GA 30030-1707 |
| Street Address |
23 WARREN ST SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30317-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871661702 | Lee A Cohen | Social Worker | 23 Warren St Se, Atlanta, GA 30317-2201 | 2006-11-30 |
| 1023419181 | Genoa Healthcare, LLC | Pharmacy | 23 Warren St Se, Atlanta, GA 30317-2201 | 2014-09-09 |
| 1992105589 | Genoa Healthcare, LLC | Pharmacy | 23 Warren St Se, Atlanta, GA 30317-2201 | 2014-09-02 |
| 1467880211 | Rachel Weissman | Social Worker | 23 Warren St Se, Atlanta, GA 30317-2201 | 2013-10-14 |
| 1518275114 | David Crow | Social Worker | 23 Warren St Se, Atlanta, GA 30317-2201 | 2010-09-16 |
| 1336364751 | Kathryn B. Houman | Counselor | 23 Warren St Se, Atlanta, GA 30317-2201 | 2007-04-13 |
| 1659493724 | Earnestine B Gray | Registered Nurse | 23 Warren St Se, Atlanta, GA 30317-2201 | 2007-04-06 |
| 1285759688 | Dekalb Community Service Board | Community/Behavioral Health | 23 Warren St Se, Atlanta, GA 30317-2201 | 2007-03-21 |
| 1316078975 | Anthony Leon Nealy | Psychiatry & Neurology | 23 Warren St Se, Atlanta, GA 30317-2201 | 2007-03-07 |
| 1295864783 | Jessie L Mayfield-gathany | Social Worker | 23 Warren St Se, Atlanta, GA 30317-2201 | 2007-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391395 | Tara Lozano Thrutchley | Counselor | 2033 Hosea L Williams Drive Ne, Suite 2, Atlanta, GA 30317 | 2019-11-26 |
| 1689052326 | Pharmworks Group LLC | Pharmacy | 1860 Memorial Dr Se, Atlanta, GA 30317 | 2015-05-14 |
| 1891032157 | Carla Bernita Jones | Licensed Practical Nurse | 2064 Ridgedale Rd Ne, Atlanta, GA 30317 | 2013-01-07 |
| 1154428985 | Dekalb County Board of Health | Public Health or Welfare | 2006 Hosea Williams Dr., Atlanta, GA 30317 | 2006-09-20 |
| 1548228034 | Yuri Okuizumi Wu | Pediatrics | 35 Whitefoord Ave Se, Atlanta, GA 30317 | 2006-05-03 |
| 1093052359 | Third Day Ministry | Religious Nonmedical Practitioner | 2064 Ridgedale Rd Ne, Atlanta, GA 30317 | 2013-01-07 |
| 1548215254 | Adrian Gendell Bonser | Dentist | 30 Warren St, Atlanta, GA 30317 | 2006-05-23 |
| 1245284041 | Magdy Attia | Dentist | 30 Warren St, Atlanta, GA 30317 | 2006-05-19 |
| 1245845288 | Jennie Gray Mulligan | Social Worker | 1911 Hallman St Ne, Atlanta, GA 30317-1001 | 2020-09-15 |
| 1942837125 | Kathryn Caracappa Boulet | Counselor | 1942 Delano Dr Ne, Atlanta, GA 30317-1009 | 2020-03-26 |
| Find all providers in zip 30317 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093312464 | Gloria Rinomhota | Pharmacist | 25 Peachtree St Sw # Se, Atlanta, GA 30303-3140 | 2020-10-07 |
| 1760098404 | Lisa Ann Mcwhorter Loux | Pharmacist | 57 Executive Park S Ste 400, Atlanta, GA 30329-2249 | 2020-09-18 |
| 1073124178 | Erin Marriott | Pharmacist | 171 17th St Nw Ste 1400, Atlanta, GA 30363-1069 | 2020-08-12 |
| 1447869797 | Caitlyn Sue Elmes | Pharmacist | 756 Bellemeade Ave Nw, Atlanta, GA 30318-3104 | 2020-07-23 |
| 1700404241 | Hoang Anh Rebecca Phan | Pharmacist | 1160 Johnson Fy Rd Ne Unit 1475, Atlanta, GA 30342-2356 | 2020-07-10 |
| 1073130597 | Tri Minh Phan | Pharmacist | 755 Mount Vernon Hwy Ne Ste 450, Atlanta, GA 30328-4292 | 2020-06-30 |
| 1649894411 | Lisa Aquillano | Pharmacist | 12 Executive Park Dr Ne Ste 556, Atlanta, GA 30329-2206 | 2020-06-08 |
| 1417570565 | Raidel Redondo | Pharmacist | 1100 Hammond Dr Ste 500, Atlanta, GA 30328-8191 | 2020-05-23 |
| 1720601255 | Dawn Lieber Sasine | Pharmacist | 164 W Wieuca Rd Ne Ste 7, Atlanta, GA 30342-3231 | 2020-05-19 |
| 1821617119 | Erin Jessica Searles | Pharmacist | 424 Decatur St Se Ste 100, Atlanta, GA 30312-1848 | 2020-04-16 |
| Find all providers in ATLANTA | ||||
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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.