SUDHARSAN PERIYASAMY THANDAVAN (NPI# 1457726663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457726663 |
Entity Type | Individual |
Full Name | SUDHARSAN PERIYASAMY THANDAVAN |
Credential | PHD |
Practice Address |
2744 Washington Rd Augusta GA 30909-2218 |
Practice Telephone | 7067334277 |
Mailing Telephone | 7067334277 |
Enumeration Date | 2015-12-14 |
Last Update Date | 2015-12-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH028705 | GA | Pharmacy Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | BLUECROSS BLUESHEILD | UIJ945A15732 | 01 |
Street Address |
2744 WASHINGTON RD |
City | AUGUSTA |
State | GA |
Zip Code | 30909-2218 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932378114 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2744 Washington Rd, Augusta, GA 30909-2218 | 2008-02-21 |
1588271456 | Vincent Joseph Nguyen | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2020-09-25 |
1134734775 | Shelley Tau | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2020-09-10 |
1659866507 | Minju Park | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2018-06-23 |
1184157463 | Brandon Harris | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2017-04-04 |
1700161213 | Gregory Emmett Drewry | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2011-10-15 |
1174808745 | Paula J Wilde | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2011-10-14 |
1912282716 | Terri F Mckettrick | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2011-10-12 |
1669754560 | David Cathcart | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2011-09-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
Find all providers in zip 30909 |
Taxonomy Code | 1835P0018X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316276033 | Susan Christine Fagan | Pharmacist | Hm 1220 1120 15th Street, University of Georgia College of Pharmacy, Augusta, GA 30912 | 2009-12-08 |
1609491281 | Melinda Kezer Drylie | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-10 |
1669009619 | Dalton Nuse | Pharmacist | 1510 Ohio St, Augusta, KS 67010-2189 | 2020-03-26 |
1740787472 | Katherine Donnan | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2018-04-09 |
1396244034 | Reid Wallace Griffin | Pharmacist | 1537 Walton Way, Augusta, GA 30904-3764 | 2018-02-08 |
1619499910 | Chantheara Long | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2017-07-09 |
1902274921 | Anishka Walker | Pharmacist | 950 15th St, Charlie Norwood Vamc - Pharmacy Department, Augusta, GA 30901-2608 | 2015-09-08 |
1073992020 | Kathleen Cleary | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2015-05-22 |
1477946531 | Amber Ladak | Pharmacist | 1120 15th St, Augusta, GA 30912-0004 | 2015-03-13 |
1699165548 | Tim Robinson | Pharmacist | 1120 15th St, Bi-2101, Augusta, GA 30912-0004 | 2015-01-30 |
Find all providers in AUGUSTA |
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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.