MOODYCARE INC. (NPI# 1912976630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912976630 |
| Entity Type | Organization |
| Organization Name | MOODYCARE INC. |
| Other Organization Name | COLISEUM PARK PROFESSIONAL PHARMACY |
| Practice Address |
380 Hospital Dr. Ste 175-a Macon GA 31217 |
| Practice Telephone | 4787455431 |
| Practice Fax Number | 4787654359 |
| Mailing Telephone | 4787455431 |
| Mailing Fax Number | 4787654359 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT BENJAMIN MOODY III (PRESIDENT) |
| Authorized Official Telephone | 4787455431 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | PHRE004996 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP OR NABP NUMBER | 1122376 | 01 |
| Other Name | Type Code |
|---|---|
| Coliseum Park Professional Pharmacy | Doing Business As Name - Organization |
| Street Address |
380 HOSPITAL DR. STE 175-A |
| City | MACON |
| State | GA |
| Zip Code | 31217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235110891 | David Wendell Mckinney | Anesthesiology | 380 Hospital Dr., Suite 410, Macon, GA 31217 | 2005-11-10 |
| 1922370105 | Josh Leslie Yeomans | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 31217 | 2012-02-02 |
| 1568782407 | Natasha Anne Nichols Parker | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 31217-8014 | 2010-06-02 |
| 1982848974 | Rebecca Lynn Veal | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 31217 | 2009-04-22 |
| 1558501007 | Kristy Dawn Savage | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 31217 | 2009-02-24 |
| 1427209113 | Nina Marie Stone | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 31217-8014 | 2008-10-01 |
| 1407923840 | Jennifer Backer Hall | Anesthesiology | 380 Hospital Dr., Suite 410, Macon, GA 31217 | 2006-11-29 |
| 1689620536 | Dennis Leo Glaude | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 31217-8014 | 2006-05-25 |
| 1477528826 | Jason Edward Butler | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Suite 410, Macon, GA 30317-8014 | 2006-02-21 |
| 1023098977 | Angela D Jenkins I | Nurse Anesthetist, Certified Registered | 380 Hospital Dr., Ste 410, Macon, GA 31217-8014 | 2006-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326535998 | Khuzema Mohsin | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Building A, Suite 430, Macon, GA 31217 | 2018-04-18 |
| 1083135271 | Angela Polk | Nurse Practitioner | 310 Hospital Dr Ste 305, Macon, GA 31217 | 2017-06-28 |
| 1235662305 | Natalie Rodziewicz | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Suite 430, Macon, GA 31217 | 2017-04-06 |
| 1427430180 | Brett Forehand | Nurse Practitioner | 330 Hospital Dr Ste 304, Macon, GA 31217 | 2015-06-18 |
| 1376772640 | Beverly Barksdale Sanders IIi | Internal Medicine | 330 Hospital Dr., Ste. 304, Macon, GA 31217 | 2009-07-08 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 1821274267 | Mary Charmaine Estrella Campana | Physical Therapist | 380 Hospital Drive, Building A, Ste. 430, Macon, GA 31217 | 2008-01-16 |
| 1033300785 | Joann Sams Sinclair | Nurse Practitioner | 4164 Riggins Mill Road, Macon, GA 31217 | 2007-08-07 |
| 1376689737 | Grier Godfrey | Dentist | Macon-bibb County Health Department, 171 Emery Highway, Macon, GA 31217 | 2007-01-30 |
| 1053408328 | Sujatha K. Reddy | Psychiatry & Neurology | 175 Emery Highway, Macon, GA 31217 | 2006-10-06 |
| Find all providers in zip 31217 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
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|---|---|---|---|---|
| 1720603756 | Medical-pharmacy Associates of Georgia, LLC | Pharmacy | 1425 Georgia Ave Ste 1, Macon, GA 31201-6546 | 2020-06-16 |
| 1730632829 | Pharmscript of Ga LLC | Pharmacy | 4611 Ivey Dr Ste 850, Macon, GA 31206-8819 | 2016-07-26 |
| 1750747622 | Cardinal Health Pharmacy Services LLC | Pharmacy | 770 Walnut St Ste 100, Macon, GA 31201-7307 | 2016-01-08 |
| 1093087090 | M&e Pharmacy Services Inc | Pharmacy | 1193 Forsyth St, Macon, GA 31201-1735 | 2012-02-07 |
| 1760511547 | Chichesters Ingleside | Pharmacy | 3051 Vineville Ave, Macon, GA 31204-2460 | 2007-03-05 |
| 1326110107 | Unionville Discount Pharmacy Inc | Pharmacy | 1381 Pio Nono Ave, Macon, GA 31204-4633 | 2006-11-15 |
| 1366551624 | Central Georgia Cancer Care PC | Pharmacy | 800 1st St Ste 415, Macon, GA 31201-8300 | 2006-08-30 |
| 1841216413 | Freds Stores of Tennessee Inc | Pharmacy | 59 Frontage Rd, Macon, MS 39341 | 2006-07-15 |
| 1104858133 | Freds Stores of Tennessee Inc | Pharmacy | 1540 Eisenhower Pkwy, Macon, GA 31206-3153 | 2006-07-07 |
| 1003884255 | Bws Major Management Systems | Pharmacy | 635 Pio Nono Ave, Macon, GA 31204-3531 | 2006-03-12 |
| Find all providers in MACON | ||||
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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.