COLQUITT COUNTY HOSPITAL AUTHORITY (NPI# 1669937264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669937264 |
| Entity Type | Organization |
| Organization Name | COLQUITT COUNTY HOSPITAL AUTHORITY |
| Practice Address |
3131 S Main St Moultrie GA 31768-6925 |
| Mailing Address |
Po Box 40 Moultrie GA 31776-0040 |
| Practice Telephone | 2298903587 |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |
| Authorized Official Name | JESSICA S JORDAN (COMPLIANCE OFFICER) |
| Authorized Official Telephone | 2299853420 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLQUITT COUNTY HOSPITAL AUTHORITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Colquitt Regional Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538283965 | Colquitt County Hospital Authority | Durable Medical Equipment & Medical Supplies | 3131 S Main St, Moultrie, GA 31768-6925 | 2007-03-19 |
| Street Address |
3131 S MAIN ST |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31768-6925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255323564 | Dale Mcgregor | Emergency Medicine | 3131 S Main St, Moultrie, GA 31768-6925 | 2005-08-22 |
| 1144861485 | Rebecca Lee Hayes | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-10-07 |
| 1942865480 | Colquitt Regional Pathology, LLC | Pathology | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-05-09 |
| 1407331143 | Christopher Neil Medders | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-09-28 |
| 1255832671 | Alexa Smith | Occupational Therapist | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-02-21 |
| 1346757481 | Jeffery W Roberts | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-01-10 |
| 1720593239 | Colquitt Regional Medical Center | Ambulance | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-12-06 |
| 1689188906 | Mary Ann Waller | Speech-Language Pathologist | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-11-22 |
| 1063923688 | Radiology Associates of Moultrie LLC | Radiology | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-10-23 |
| 1629590898 | Amanda Jackson | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-07-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975452 | Zachary Schiffer | Specialist/Technologist | 3131 S Main Street, Moultrie, GA 31768 | 2020-02-27 |
| 1326697731 | Daisy Concierge Care | Nursing Care | 437 S. Morris Rd Lt 1, Moultrie, GA 31768 | 2019-09-09 |
| 1194208751 | Regina Mercer Ward | Nurse Practitioner | 1724 Villa Dr Sw, Moultrie, GA 31768 | 2018-09-10 |
| 1225473630 | Moultrie Orthodontics, P.C. | Clinic/Center | 12 Longleaf Office Park, Moultrie, GA 31768 | 2013-04-30 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1821382672 | Colquitt Regional Ob/gyn, LLC | Obstetrics & Gynecology | 3 Sweet Bay Ct, Moultrie, GA 31768 | 2011-06-08 |
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1508177445 | Cherokee Rose Emergency Physicians | Emergency Medicine | 3131 South Main Street, Moultrie, GA 31768 | 2010-06-25 |
| 1023299963 | Hetal Patel | Counselor | 600 2nd St South East, Moultrie, GA 31768 | 2007-11-20 |
| 1720146756 | William C Byrd Inc | Assisted Living Facility | 498 5th Street Se, Moultrie, GA 31768 | 2006-12-04 |
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| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487128799 | Niday Drug Company LLC | Pharmacy | 2707 S Main St, Moultrie, GA 31768-6906 | 2019-01-20 |
| 1295283620 | Convenient Rx LLC | Pharmacy | 640 Veterans Pkwy N, Moultrie, GA 31788 | 2016-09-14 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1558427468 | Hospital Pharmacy of Moultrie Inc | Pharmacy | 203 31st Ave Se, Moultrie, GA 31768-6703 | 2006-12-28 |
| 1295729861 | South Georgia Pharmacy Services Inc | Pharmacy | 720 W Central Ave, Moultrie, GA 31768-3560 | 2005-09-09 |
| 1801931555 | Chancy Drugs Moultrie LLC | Pharmacy | 101 N Main St, Moultrie, GA 31768-3863 | 2007-02-20 |
| 1841393501 | Georgia Cvs Pharmacy LLC | Pharmacy | 1027 S Main St, Moultrie, GA 31768-5438 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
| 1184225526 | Svdp Georgia Community Pharmacy LLC | Pharmacy | 2050 Chamblee Tucker Rd Ste C, Chamblee, GA 30341-3343 | 2020-11-03 |
| 1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
| 1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
| 1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
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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.