CELESTINA PAK (NPI# 1508497256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508497256 |
| Entity Type | Individual |
| Full Name | CELESTINA PAK |
| Practice Address |
5664 Jonesboro Rd Lake City GA 30260-3808 |
| Practice Telephone | 7709600162 |
| Practice Fax Number | 7709602889 |
| Mailing Telephone | 7709600162 |
| Mailing Fax Number | 7709602889 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH028920 | GA | Pharmacy Service Providers |
| Street Address |
5664 JONESBORO RD |
| City | LAKE CITY |
| State | GA |
| Zip Code | 30260-3808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093749988 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 5664 Jonesboro Rd, Lake City, GA 30260-3808 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| 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 |
|---|---|---|---|---|
| 1548519507 | Robert Bruce Page | Pharmacist | 401 West Thomas St, Lake City, SC 29560 | 2012-09-06 |
| 1548690712 | Kristi Avinger | Pharmacist | 619 S Marion Ave, Lake City, FL 32025-5808 | 2013-11-25 |
| 1447572037 | Crystal Anne Ferwerda | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2010-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445747 | Hiep Hoang Do | Pharmacist | 801 Burns Estates Dr, Lilburn, GA 30047-3484 | 2020-10-17 |
| 1518565902 | Edward Edeh | Pharmacist | 1232 South Hairstoh Road, Stone Mountain, GA 30088 | 2020-10-16 |
| 1548868342 | Jackson Gathuru Ngugi | Pharmacist | 193 Anniversary Ln, Acworth, GA 30102-2045 | 2020-10-14 |
| 1568086494 | Lynn Berner Marshall | Pharmacist | 3823 Club Forest Dr, Peachtree Corners, GA 30092-2369 | 2020-06-06 |
| 1295357325 | Rhonda Ireland | Pharmacist | 125 Main Street Marketplace, Cartersville, GA 30120 | 2020-05-12 |
| 1073132676 | Khushboo S Rhodes | Pharmacist | 3101 Roswell Rd Ste 132, Marietta, GA 30062-5523 | 2020-04-14 |
| 1194354647 | Deanna W Mcewen | Pharmacist | 1720 Epps Bridge Road, Athens, GA 30606-6132 | 2020-04-06 |
| 1104452663 | Latrena Solomon | Pharmacist | 1750 Highway 138 E, Stockbridge, GA 30281-2810 | 2020-03-17 |
| 1497389597 | Rx Healthcare Ltd | Pharmacist | 2136 W Park Ct Ste I, Stone Mountain, GA 30087-3528 | 2020-02-27 |
| 1972136273 | Shannon Sulik | Pharmacist | 774 Highway 96, Bonaire, GA 31005-3300 | 2020-02-15 |
| Find all providers with the same taxonomy | ||||
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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.