NORTHWEST GEORGIA ONCOLOGY CENTERS, PC (NPI# 1790813749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790813749 |
| Entity Type | Organization |
| Organization Name | NORTHWEST GEORGIA ONCOLOGY CENTERS, PC |
| Practice Address |
6002 Professional Pkwy Ste 220 Douglasville GA 30134-5600 |
| Mailing Address |
1700 Hospital South Dr Suite 300 Austell GA 30106-6810 |
| Practice Telephone | 6787159690 |
| Practice Fax Number | 6785817180 |
| Mailing Telephone | 7709442830 |
| Mailing Fax Number | 6785817170 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2010-12-01 |
| Authorized Official Name | DR. BRUCE J GOULD (MD PHYSICIAN) |
| Authorized Official Telephone | 7702815100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 0741780007 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | SUPPLIER NPI NUMBER (DOUGLASVILLE) | 1790813749 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154864841 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 2500 Hospital Boulevard, Suite 490, Roswell, GA 30076-4907 | 2016-11-29 |
| 1790951788 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 148 Bill Carruth Pkwy, Suite 260, Hiram, GA 30141-3754 | 2008-04-30 |
| 1700914926 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 200 Allen Memorial Dr, Ste 302-b, Bremen, GA 30110-2012 | 2007-03-01 |
| 1124156310 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 157 Clinic Ave, Ste 101, Carrollton, GA 30117-4454 | 2007-03-01 |
| 1992833941 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 15 Reinhardt College Pkwy, Suite 110, Canton, GA 30114-2493 | 2007-03-01 |
| 1083742175 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 100 Market Place Blvd, Ste 200, Cartersville, GA 30121-8718 | 2007-03-01 |
| 1801924857 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 620 J L White Dr, Ste 100, Jasper, GA 30143-4896 | 2007-03-01 |
| 1700914751 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 340 Kennestone Hospital Blvd, Ste 200, Marietta, GA 30060-1152 | 2007-03-01 |
| 1619005667 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 705 Dallas Hwy, Ste 205, Villa Rica, GA 30180-1247 | 2007-03-01 |
| 1588792881 | Northwest Georgia Oncology Centers, PC | Durable Medical Equipment & Medical Supplies | 1700 Hospital South Dr, Suite 300, Austell, GA 30106-6810 | 2007-03-01 |
| Street Address |
6002 PROFESSIONAL PKWY STE 220 |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30134-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670804 | John Nino | Otolaryngology | 6002 Professional Pkwy, Suite 100, Douglasville, GA 30134-5600 | 2005-06-22 |
| 1083078414 | Kaycee Green | Specialist/Technologist | 6002 Professional Pkwy, Douglasville, GA 30134-5600 | 2016-04-12 |
| 1427369727 | Diane L Kaplan | Audiologist | 6002 Professional Pkwy, 100, Douglasville, GA 30134-5600 | 2010-07-01 |
| 1629399555 | Wellstar Bi-county Ent, LLC | Otolaryngology | 6002 Professional Pkwy, Suite 100, Douglasville, GA 30134-5600 | 2010-06-15 |
| 1205090115 | Karen Marie Gunderson | Physician Assistant | 6002 Professional Pkwy, Suite 220, Douglasville, GA 30134-5600 | 2008-07-10 |
| 1164566196 | Christopher Michael Burket | Orthopaedic Surgery | 6002 Professional Pkwy, Douglasville, GA 30134-5600 | 2007-02-15 |
| 1376559856 | Eddie D. Coverson | Physical Therapist | 6002 Professional Pkwy, Suite 140, Douglasville, GA 30134-5600 | 2006-08-01 |
| 1740239730 | George G Mygatt | Urology | 6002 Professional Pkwy, Suite 280, Douglasville, GA 30134-5600 | 2006-05-08 |
| 1649259599 | Helen Rosemary Stockwell | Nurse Practitioner | 6002 Professional Pkwy, Suite 200, Douglasville, GA 30134-5600 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1548822901 | Sweet Resolve LLC | Nurse Practitioner | 4318 Ridge Rd, Ste 111 Pmb 1017, Douglasville, GA 30134 | 2019-07-05 |
| 1598328791 | Straight Street Life Center Inc | Case Manager/Care Coordinator | 12461 Veterans Memorial, Douglasville, GA 30134 | 2019-04-15 |
| 1174014930 | Caitlin Waldrip | Chiropractor | 8326a Office Park Dr., Douglasville, GA 30134 | 2018-05-28 |
| 1861901050 | Michelle Denise Winston | Licensed Practical Nurse | 6497 E Strickland, Douglasville, GA 30134 | 2017-09-20 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1497135131 | Patricia Warren | Social Worker | 8317 Office Park Drive Ste.#e, Douglasville, GA 30134 | 2015-06-08 |
| 1457747321 | Kidz Rock Therapy Services, LLC | Occupational Therapist | 6732 West Spring Street, Douglasville, GA 30134 | 2015-04-08 |
| 1386068476 | Naa Y Oden | Psychologist | 4813 Ridge Rd Ste 111-639, Douglasville, GA 30134 | 2014-02-10 |
| 1467893271 | American Ems | Ambulance | 7240 Bankhead Hwy, Douglasville, GA 30134 | 2013-07-09 |
| Find all providers in zip 30134 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922522002 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2710 Fairburn Rd, Douglasville, GA 30135-2942 | 2017-07-31 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1720467715 | Sean Todd-crooks | Durable Medical Equipment & Medical Supplies | 3881 Erica Cir, Douglasville, GA 30135-4117 | 2015-05-22 |
| 1730443094 | Empirical Medical Equipment Inc. | Durable Medical Equipment & Medical Supplies | 8318 Duralee Ln Ste 204, Douglasville, GA 30134 | 2012-07-01 |
| 1811256605 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3674 Highway 5, Douglasville, GA 30135-2364 | 2012-05-14 |
| 1518286202 | Epw Enterprise LLC | Durable Medical Equipment & Medical Supplies | 3686 Lower Creek Dr, Douglasville, GA 30135-4291 | 2010-05-20 |
| 1326282567 | Kay One Source LLC | Durable Medical Equipment & Medical Supplies | 1911 David Dr, Douglasville, GA 30135-6824 | 2009-04-30 |
| 1053565812 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2701 Fairburn Rd, Douglasville, GA 30135-2941 | 2008-11-06 |
| 1023266921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3851 Chapel Hill Rd, Douglasville, GA 30135-7287 | 2008-09-04 |
| 1164682563 | Magalie Guerrier | Durable Medical Equipment & Medical Supplies | 133 Carrington Ln, Douglasville, GA 30135 | 2008-06-10 |
| Find all providers in DOUGLASVILLE | ||||
| City | DOUGLASVILLE |
| Zip Code | 30134 |
Please comment or provide details below to improve the information on NORTHWEST GEORGIA ONCOLOGY CENTERS, PC.
| 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.