SOUTHERN PAIN INSTITUTE P C (NPI# 1750665584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750665584 |
Entity Type | Organization |
Organization Name | SOUTHERN PAIN INSTITUTE P C |
Other Organization Name | PARISH PHARMACY |
Practice Address |
1975 Highway 54 W Ste 100 Fayetteville GA 30214-4794 |
Mailing Address |
1975 Highway 54 W Suite 100 Fayetteville GA 30214-4794 |
Practice Telephone | 7706315158 |
Practice Fax Number | 7706323731 |
Mailing Telephone | 7706315158 |
Mailing Fax Number | 4045917959 |
Enumeration Date | 2011-09-28 |
Last Update Date | 2013-03-20 |
Authorized Official Name | LYNN CLAVO (CHIEF PHARMACIST) |
Authorized Official Telephone | 7703133380 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE009784 | GA | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 1161784 | 01 |
Other Name | Type Code |
---|---|
Parish Pharmacy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174836845 | Southern Pain Institute P C | Pharmacy | 1501 Milstead Rd Ne Ste 140, Conyers, GA 30012-3849 | 2010-07-22 |
Street Address |
1975 HIGHWAY 54 W STE 100 |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30214-4794 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
Find all providers in zip 30214 |
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 |
---|---|---|---|---|
1639705957 | Cape Fear Discount Drug - Ramsey, LLC | Pharmacy | 4417 Ramsey St, Fayetteville, NC 28311-2134 | 2020-03-18 |
1003391491 | Platinum Pharmacy | Pharmacy | 935 Lanier Ave W Ste 1008, Fayetteville, GA 30214-7434 | 2018-10-01 |
1649635459 | Walmart Inc. | Pharmacy | 660 W Martin Luther King Blvd, Fayetteville, AR 72701-6443 | 2015-12-21 |
1003203878 | R & R Medical Inc | Pharmacy | 2127 N Center St, Suite 1, Fayetteville, AR 72701-9449 | 2015-04-20 |
1598171910 | Express Discount Pharmacy LLC | Pharmacy | 1905 Skibo Rd Ste 104, Fayetteville, NC 28314-0261 | 2014-07-07 |
1760803035 | Walgreen Co | Pharmacy | 4015 W Wedington Dr, Fayetteville, AR 72704-5733 | 2014-01-03 |
1740535715 | Harris Teeter, LLC | Pharmacy | 3050 Traemoor Village Dr, Fayetteville, NC 28306 | 2012-07-17 |
1093013591 | Nugen Pharmacy LLC | Pharmacy | 101 Yorktown Dr Ste 102, Fayetteville, GA 30214-1568 | 2011-03-08 |
1477880185 | Carlie Cs of Cliffdale LLC | Pharmacy | 690 S Reilly Rd, Fayetteville, NC 28314-5626 | 2009-11-17 |
1922246818 | Calhoun Family Pharmacy Inc | Pharmacy | 4417 Ramsey Street, Fayetteville, NC 28311 | 2009-01-30 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 30214 |
Please comment or provide details below to improve the information on SOUTHERN PAIN INSTITUTE P C.
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.