PITTARD CLINIC LLC (NPI# 1912528696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912528696 |
| Entity Type | Organization |
| Organization Name | PITTARD CLINIC LLC |
| Practice Address |
1654 Falls Rd Toccoa GA 30577 |
| Practice Telephone | 7068864420 |
| Practice Fax Number | 7068864410 |
| Mailing Telephone | 7068864420 |
| Mailing Fax Number | 7068864410 |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |
| Authorized Official Name | MARIDAN H PITTARD (OWNER) |
| Authorized Official Telephone | 7068864420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Street Address |
1654 FALLS RD |
| City | TOCCOA |
| State | GA |
| Zip Code | 30577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220513 | Jennifer Lynn Harper | Counselor | 46 Rice Lewis Gilliard Way, Toccoa, GA 30577 | 2020-06-19 |
| 1518313733 | Shellei Adams | Occupational Therapist | 23 Big A Rd, Toccoa, GA 30577 | 2016-05-06 |
| 1902212814 | Rebecca Coursey | Counselor | 1763 Fernside Dr., Avita Community Partners, Toccoa, GA 30577 | 2014-07-11 |
| 1427478742 | Cynthia Hemphill Wansley | Pharmacist | 3886 Georgia Highway 17, Toccoa, GA 30577 | 2014-04-25 |
| 1265850168 | Karen Kelley Colwell | Pharmacist | 3886 Hwy 17, Toccoa, GA 30577 | 2014-03-29 |
| 1972808160 | Cossar Chiropractic | Chiropractor | 2766 Ga Hwy 17, Toccoa, GA 30577 | 2011-01-19 |
| 1811216070 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 130 Haynes St, Toccoa, GA 30577 | 2010-05-26 |
| 1942435516 | Meadows Surgical Arts | Specialist | 203 Remsdale Rd, Toccoa, GA 30577 | 2009-05-26 |
| 1609011816 | Bryan Gerald Wood | Pharmacist | 102 N Sage Street, Stewart's Downtown Discount Drugs, Toccoa, GA 30577 | 2008-12-03 |
| 1750555652 | Joseph Hill Wilbanks Sr. | Dentist | 278 E Doyle Street, Toccoa, GA 30577 | 2008-04-22 |
| Find all providers in zip 30577 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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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.