RIVER EDGE BEHAVIORAL HEALTH CENTER (NPI# 1972085769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972085769 |
| Entity Type | Organization |
| Organization Name | RIVER EDGE BEHAVIORAL HEALTH CENTER |
| Other Organization Name | RIVER EDGE BOULEVARD PHARMACY |
| Practice Address |
265 Boulevard Ne Atlanta GA 30312-1208 |
| Mailing Address |
175 Emery Hwy Macon GA 31217-3692 |
| Practice Telephone | 4046658550 |
| Practice Fax Number | 4046658693 |
| Mailing Telephone | 4788037700 |
| Mailing Fax Number | 4788038598 |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |
| Authorized Official Name | JESSICA OAKES (BILLING MANAGER) |
| Authorized Official Telephone | 4788037809 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | RIVER EDGE BEHAVIORAL HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010434 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GEORGIA PHARMACY LICENSE | PHRE010434 | 01 |
| Other Name | Type Code |
|---|---|
| River Edge Boulevard Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467965848 | River Edge Behavioral Health Center | Community/Behavioral Health | 7741 Roswell Rd Ste A, Atlanta, GA 30350-4845 | 2017-11-08 |
| 1164961876 | River Edge Behavioral Health Center | Community/Behavioral Health | 281 Carl Vinson Pkwy, Suite D, Warner Robins, GA 31088-5824 | 2017-02-14 |
| 1730483306 | River Edge Behavioral Health Center | Community/Behavioral Health | 1881 Twin Pines Dr, Macon, GA 31211-1237 | 2010-12-22 |
| 1164732384 | River Edge Behavioral Health Center | Community/Behavioral Health | 1243 First Ave, Macn, GA 31204-4177 | 2010-10-21 |
| 1023204864 | River Edge Behavioral Health Center | Community/Behavioral Health | 952 Main St, Jeffersonville, GA 31044-3727 | 2007-09-14 |
| 1669668414 | River Edge Behavioral Health Center | Community/Behavioral Health | 530 Settlement Rd Ste A, Gray, GA 31032-6030 | 2007-09-14 |
| 1295899466 | River Edge Behavioral Health Center | Community/Behavioral Health | 750 Baconsfield Dr, Macon, GA 31211-1491 | 2006-12-21 |
| 1962564963 | River Edge Behavioral Health Center | Community/Behavioral Health | 4164 Riggins Mill Rd, Macon, GA 31217-5440 | 2006-12-15 |
| 1487716577 | River Edge Behavioral Health Center | Community/Behavioral Health | 151 Childs St, Gray, GA 31032-5637 | 2006-12-14 |
| 1104988351 | River Edge Behavioral Health Center | Community/Behavioral Health | 626 Spring St, Macon, GA 31201-2028 | 2006-12-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RIVER EDGE BEHAVIORAL HEALTH CENTER | 175 Emery Hwy, Macon, GA 31217-3692 |
| Street Address |
265 BOULEVARD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316974447 | Jasmine Pugh Taylor | Psychiatry & Neurology | 265 Boulevard Ne, Atlanta, GA 30312 | 2006-06-26 |
| 1851945356 | Summer Beckett Davies | Orthopaedic Surgery | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2019-08-01 |
| 1124531504 | River Edge Behavioral Health Center | Community/Behavioral Health | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2017-11-08 |
| 1831541754 | Chiazor Eziakor | Nurse Practitioner | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2016-07-02 |
| 1366810426 | Vicki Karen Karnes | Registered Nurse | 265 Boulevard Ne, 4th Floor Attn: Pat Jackson, Atlanta, GA 30312-1208 | 2015-09-07 |
| 1073786679 | Monique Anetria Brooks | Counselor | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2008-04-04 |
| 1114104478 | Cecelia Marie Mack | Counselor | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2008-01-29 |
| 1427231927 | Virginia Hicks Taylor Mack | Counselor | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2007-12-07 |
| 1932389350 | Frederick Lawson Bailey | Counselor | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2007-11-14 |
| 1801096466 | Donna Endsley Real | Social Worker | 265 Boulevard Ne, Atlanta, GA 30312-1208 | 2007-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| 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 |
|---|---|---|---|---|
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1407492119 | Capsule Atlanta LLC | Pharmacy | 867 Peachtree St Ne Ste 102, Atlanta, GA 30308-1380 | 2019-11-18 |
| 1861978793 | Uhs of Peachford Lp | Pharmacy | 2150 Peachford Rd Ste D, Atlanta, GA 30338 | 2018-07-13 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1912357641 | Headland Pharmacy LLC | Pharmacy | 2973 Headland Drive, Suite B, Atlanta, GA 30331 | 2016-06-14 |
| 1285022277 | Express Food & Pharmacy Investment LLC | Pharmacy | 2111 Campbellton Rd Sw, Atlanta, GA 30311-4605 | 2014-12-30 |
| 1881024479 | Camp Creek Village Pharmacy Inc. | Pharmacy | 3220 Butner Rd Sw Suite #130, Atlanta, GA 30331 | 2013-11-18 |
| 1487093662 | Pharm Holdings | Pharmacy | 102 E Allday St, Atlanta, TX 75551-2305 | 2013-06-20 |
| 1255676326 | Eastlake Pharmacy Inc | Pharmacy | 1308 Glenwood Ave Se, Atlanta, GA 30316-2077 | 2012-11-30 |
| 1689918468 | Wal-mart Stores East Lp | Pharmacy | 835 Martin Luther King Jr Dr Nw, Atlanta, GA 30314-3644 | 2012-11-19 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on RIVER EDGE BEHAVIORAL HEALTH CENTER.
| 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.