SAMSON MERGER SUB, LLC (NPI# 1982028718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982028718 |
| Entity Type | Organization |
| Organization Name | SAMSON MERGER SUB, LLC |
| Other Organization Name | HARVEY'S SUPERMARKET PHARMACY #5767 |
| Practice Address |
603 Northside Dr W Statesboro GA 30458-5378 |
| Mailing Address |
Po Box 2209 Jacksonville FL 32203-2209 |
| Practice Telephone | 9047835578 |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |
| Authorized Official Name | M. SANDLIN GRIMM (SECRETARY) |
| Authorized Official Telephone | 9047835000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Harvey's Supermarket Pharmacy #5767 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982020053 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 1737 E Oak St, Arcadia, FL 34266-8925 | 2014-03-12 |
| 1609290436 | Samson Merger Sub, LLC | Pharmacy | 830 W Oak St, Mc Rae, GA 31055-1531 | 2014-02-14 |
| 1528482353 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 284 Hyde Park Cmns, Brunswick, GA 31523-6601 | 2014-02-14 |
| 1396168571 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 2500 Burnsed Blvd, The Villages, FL 32163 | 2014-01-24 |
| 1447672860 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 8837 N 56th St, Temple Terrace, FL 33617-6203 | 2014-01-21 |
| 1245652668 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 2770 E Fowler Ave, Tampa, FL 33612-6277 | 2014-01-21 |
| 1760804173 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 13508 N Florida Ave, Tampa, FL 33613-3213 | 2014-01-21 |
| 1467874875 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 7131 N Us Highway 441, Ocala, FL 34475-1215 | 2014-01-21 |
| 1750703161 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 6400 Massachusetts Ave, New Port Richey, FL 34653-2532 | 2014-01-21 |
| 1063834489 | Samson Merger Sub, LLC | Durable Medical Equipment & Medical Supplies | 11310 Se Us Highway 301, Belleview, FL 34420-4475 | 2014-01-21 |
| Street Address |
603 NORTHSIDE DR W |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-5378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457511446 | Mandy Conner Davenport | Pharmacist | 603 Northside Dr W, Statesboro, GA 30458-5378 | 2008-06-12 |
| 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 |
| 1578861431 | Georgia Southern University Health Services Pharmacy | Pharmacy | 984 Plant Dr, Statesboro, GA 30460-0001 | 2011-03-02 |
| 1922134089 | Medical Center Pharmacy of Statesboro, Inc | Pharmacy | 57 Granade St, Statesboro, GA 30458-5106 | 2007-02-25 |
| 1386770444 | Medical Center Pharmacy of Statesboro, Inc | Pharmacy | 1601 Fair Rd, Suite 1200, Statesboro, GA 30458-1698 | 2007-02-25 |
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| 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.