NORTHEAST GEORGIA MEDICAL CENTER, INC. (NPI# 1124183355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124183355 |
| Entity Type | Organization |
| Organization Name | NORTHEAST GEORGIA MEDICAL CENTER, INC. |
| Other Organization Name | DBA NGMC PHARMACY |
| Practice Address |
825 Jesse Jewell Pkwy Se Suite D Gainesville GA 30501-3830 |
| Mailing Address |
Po Box 741891 Atlanta GA 30374-1891 |
| Practice Telephone | 7705387559 |
| Mailing Telephone | 7705387559 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | BRIAN D STEINES (CFO) |
| Authorized Official Telephone | 7702193562 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00608583A | 05 | |
| GA | DEA | BN9676618 | 01 |
| GA | NCPDP | 1119987 | 01 |
| GA | STATE LICENSE | PHRE007738 | 01 |
| Other Name | Type Code |
|---|---|
| DBA NGMC Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042867 | Northeast Georgia Medical Center, Inc. | Pharmacy | 1439 Jesse Jewell Pkwy Ne, Gainesville, GA 30501-3806 | 2020-04-22 |
| 1649208927 | Northeast Georgia Medical Center, Inc. | Skilled Nursing Facility | 2020 Beverly Rd Ne, Gainesville, GA 30501-2037 | 2006-06-28 |
| 1407892706 | Northeast Georgia Medical Center, Inc. | Skilled Nursing Facility | 675 White Sulphur Road, Gainesville, GA 30501-2621 | 2006-06-22 |
| 1720015993 | Northeast Georgia Medical Center, Inc. | Rehabilitation Unit | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2006-06-26 |
| 1437185261 | Northeast Georgia Medical Center, Inc. | Psychiatric Unit | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2006-06-23 |
| 1790721942 | Northeast Georgia Medical Center, Inc. | Ambulance | 675 White Sulphur Rd, Suite 285, Gainesville, GA 30501-8921 | 2006-06-22 |
| 1427055821 | Northeast Georgia Medical Center, Inc. | General Acute Care Hospital | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2005-06-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHEAST GEORGIA MEDICAL CENTER, INC. | 743 Spring St Ne, Gainesville, GA 30501-3715 |
| Street Address |
825 JESSE JEWELL PKWY SE SUITE D |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1760862247 | Healthcare Specialty Transactions, LLC | Pharmacy | 1267 Professional Pkwy Ste 200, Gainesville, GA 30507-8705 | 2015-06-01 |
| 1982761706 | Riverside Mot Pharmacy Inc | Pharmacy | 935-b Green St, Gainesville, GA 30501 | 2007-01-02 |
| 1336218288 | Riverside Pharmacy Inc | Pharmacy | 935 Green St Nw, Gainesville, GA 30501-3325 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800271 | Macs Ltc Pharmacy Georgia LLC | Pharmacy | 1351 Oakbrook Dr Ste 110, Norcross, GA 30093-2242 | 2020-10-27 |
| 1295347516 | Kayton Pharmacy LLC | Pharmacy | 541 Forest Pkwy Ste 4, Forest Park, GA 30297-2147 | 2020-08-18 |
| 1205479771 | Welltree Pharmacy LLC | Pharmacy | 5009 Roswell Rd Ste 210, Atlanta, GA 30342-2205 | 2019-10-28 |
| 1346882735 | Mortar and Pestle, LLC | Pharmacy | 300 Mooty Bridge Rd, Lagrange, GA 30240-1881 | 2019-10-17 |
| 1134685241 | Mgp Rx, LLC | Pharmacy | 1951 Canton Rd Ste 290, Marietta, GA 30066-6300 | 2019-02-13 |
| 1326553090 | West Georgia Home Medical Equipment Co Inc | Pharmacy | 1861 Roanoke Rd Ste A, Lagrange, GA 30240-3850 | 2017-12-04 |
| 1295278166 | Prestige Pharmacy Snellville LLC | Pharmacy | 1551 Janmar Rd, Suite B, Snellville, GA 30078-5606 | 2016-11-28 |
| 1609327089 | Butler Long Term Care Solutions | Pharmacy | 10 B North Poplar St, Butler, GA 31006 | 2016-10-20 |
| 1285180711 | Vn Pharmacy LLC | Pharmacy | 5000 Buford Hwy, Suite A-106, Atlanta, GA 30341-3500 | 2016-08-25 |
| 1871953406 | South Georgia Pharmacy Services Inc | Pharmacy | 720 W Central Ave Ste 1, Moultrie, GA 31768-3560 | 2016-02-24 |
| Find all providers with the same taxonomy | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
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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.