MEDICAL CENTER PHARMACY OF STATESBORO, INC (NPI# 1922134089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922134089 |
| Entity Type | Organization |
| Organization Name | MEDICAL CENTER PHARMACY OF STATESBORO, INC |
| Practice Address |
57 Granade St Statesboro GA 30458-5106 |
| Practice Telephone | 9127645643 |
| Practice Fax Number | 9127649580 |
| Mailing Telephone | 9127645643 |
| Mailing Fax Number | 9127649580 |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. WALTER S PEASE (CFO) |
| Authorized Official Telephone | 9127645643 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE006387 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00031842A | 05 | |
| GA | DEA | AM2957720 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386770444 | Medical Center Pharmacy of Statesboro, Inc | Pharmacy | 1601 Fair Rd, Suite 1200, Statesboro, GA 30458-1698 | 2007-02-25 |
| Street Address |
57 GRANADE ST |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-5106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568450260 | Joe W Pennington | Pharmacist | 57 Granade St, Statesboro, GA 30458-5106 | 2005-10-07 |
| 1902015241 | Lisa Finch Laircey | Pharmacist | 57 Granade St, Statesboro, GA 30458-5106 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| 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 |
|---|---|---|---|---|
| 1942623889 | Freds Stores of Tennessee Inc | Pharmacy | 604 Northside Drive, Statesboro, GA 30458 | 2014-01-29 |
| 1477637627 | Sharpe Mccook Pharmacy | Pharmacy | 23630 Us Highway 80 E # A, Statesboro, GA 30461-6019 | 2006-10-24 |
| 1215942321 | Walgreen Co | Pharmacy | 613 Northside Dr E, Statesboro, GA 30458-2194 | 2006-07-29 |
| 1972546125 | Walker Pharmacy and Gifts, Inc. | Pharmacy | 2425 Northside Dr W, Statesboro, GA 30458-2153 | 2006-06-14 |
| 1003863523 | Walker Pharmacy and Gifts, Inc. | Pharmacy | 1198 Merchants Way, Statesboro, GA 30458 | 2006-05-29 |
| 1982028718 | Samson Merger Sub, LLC | Pharmacy | 603 Northside Dr W, Statesboro, GA 30458-5378 | 2014-02-14 |
| 1578861431 | Georgia Southern University Health Services Pharmacy | Pharmacy | 984 Plant Dr, Statesboro, GA 30460-0001 | 2011-03-02 |
| 1386770444 | Medical Center Pharmacy of Statesboro, Inc | Pharmacy | 1601 Fair Rd, Suite 1200, Statesboro, GA 30458-1698 | 2007-02-25 |
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|---|---|---|---|---|
| 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 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
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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.