SUDHARSAN PERIYASAMY THANDAVAN


Address: 2744 Washington Rd, Augusta, GA 30909-2218
Phone: 7067334277

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
GA BLUECROSS BLUESHEILD UIJ945A15732 01

Office Location

Street Address 2744 WASHINGTON RD
City AUGUSTA
State GA
Zip Code 30909-2218

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 1835P0018X
Grouping Pharmacy Service Providers
Classification Pharmacist
Specialization Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City AUGUSTA
Zip Code 30909

Improve Information

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Dataset Information

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.

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