MR. STACEY GLENN GIRARDEAU (NPI# 1568784494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568784494 |
Entity Type | Individual |
Full Name | MR. STACEY GLENN GIRARDEAU |
Credential | RPH |
Practice Address |
606 Brannen St Ste B Statesboro GA 30458-5184 |
Practice Telephone | 9122259279 |
Practice Fax Number | 9122259284 |
Mailing Telephone | 9122259279 |
Mailing Fax Number | 9122259284 |
Enumeration Date | 2010-02-19 |
Last Update Date | 2012-04-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | 017233 | GA | Pharmacy Service Providers |
Street Address |
606 BRANNEN ST STE B |
City | STATESBORO |
State | GA |
Zip Code | 30458-5184 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255972352 | Kimberly Kay Yaughn | Pharmacist | 606 Brannen St Ste B, Statesboro, GA 30458-5184 | 2019-10-01 |
1083987457 | Sgbs Holdings LLC | Pharmacy | 606 Brannen St Ste B, Statesboro, GA 30458-5184 | 2012-02-16 |
1306163597 | Brandon Robert Selph | Pharmacist | 606 Brannen St Ste B, Statesboro, GA 30458-5184 | 2010-04-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
Find all providers in zip 30458 |
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 |
---|---|---|---|---|
1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
1285021014 | Josh Leonard Mccook | Pharmacist | 23630a Hwy 80 E, Statesboro, GA 30461-6019 | 2015-04-20 |
1295128494 | Colleen Sacco | Pharmacist | 147 Northside Dr E, Statesboro, GA 30458-4760 | 2015-03-11 |
1780081232 | Amanda Herrin | Pharmacist | 556 Northside Dr E, Statesboro, GA 30458-2191 | 2014-11-28 |
1003220708 | Samuel Gregory Hooks | Pharmacist | 10929 Us Highway 301 S Ste 111, Statesboro, GA 30458-7774 | 2014-06-20 |
1447672951 | Mike Umbers Turnage | Pharmacist | 1601 Fair Road Suite 1200, Medical Center Pharmacy At Cotton Ridge, Statesboro, GA 30458 | 2014-01-17 |
1225475957 | Bryan Chapman | Pharmacist | 325 Northside Dr E Ste 1, Statesboro, GA 30458-4763 | 2013-06-04 |
1124301882 | Kelley Flowers Collins | Pharmacist | 516 Northside Dr E, Statesboro, GA 30458-4841 | 2011-09-20 |
1811289044 | Martha Elizabeth Toussaint | Pharmacist | 1301 Fair Rd, Statesboro, GA 30458-1734 | 2011-05-05 |
1174821334 | Minette M Sterling-ugorji | Pharmacist | 500 Northside Dr E, Statesboro, GA 30458-4841 | 2011-03-11 |
Find all providers in STATESBORO |
City | STATESBORO |
Zip Code | 30458 |
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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.