SOUTHWESTERN STATE HOSPITAL (NPI# 1386637510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386637510 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN STATE HOSPITAL |
| Practice Address |
400 S Pinetree Blvd Southwestern State Hospital Pharmacy Thomasville GA 31792-7128 |
| Mailing Address |
Po Box 1378 Patient Billing Dept Thomasville GA 31799-1378 |
| Practice Telephone | 2292273004 |
| Practice Fax Number | 2292272663 |
| Mailing Telephone | 2292273004 |
| Mailing Fax Number | 2272272663 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2009-08-18 |
| Authorized Official Name | MRS. HILARY J HOO-YOU (REGIONAL HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 2292273021 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | PHH003440 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | PHH003440 | 05 | |
| GA | MEDICARE D NAPD 1117565 | PHH003440 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548407364 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 419 N Crawford St, Community Medicaid Comp Waiver Home, Thomasville, GA 31792-5128 | 2009-01-15 |
| 1326285248 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 845 Crabapple Dr, Community Medicaid Comp Homes, Thomasville, GA 31757-1400 | 2009-01-14 |
| 1497992457 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 309a Shoreline Dr, Community Medicaid Comp Waiver Home, Thomasville, GA 31757-2577 | 2009-01-13 |
| 1841320280 | Southwestern State Hospital | Substance Abuse Rehabilitation Facility | 1500 Gillionville Rd Ste B, Albany, GA 31707-3963 | 2007-03-06 |
| 1619045291 | Southwestern State Hospital | Community/Behavioral Health | 819 Tillman St, Patient Billing Dept, Hahira, GA 31632-1451 | 2006-12-01 |
| 1366519811 | Southwestern State Hospital | Community/Behavioral Health | 200 W Oglethorpe Blvd Fl 4, Patient Billing Dept, Albany, GA 31701-6802 | 2006-11-29 |
| 1871675934 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Belmont Dr, Community Medicaid Waiver Home Chss, Thomasville, GA 31792-4725 | 2006-10-19 |
| 1851473912 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 114 Cove Landing Dr, Community Medicaid Waiver Home Rts, Thomasville, GA 31792-3883 | 2006-10-19 |
| 1881776946 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Cove Landing Dr, Community Medicaid Waiver Home Mrwp, Thomasville, GA 31792-3883 | 2006-10-19 |
| 1376645796 | Southwestern State Hospital | Community Based Residential Treatment Facility, Mental Illness | 307 Cloverdale Dr, Intensive Treatment Residence Program, Thomasville, GA 31792-4018 | 2006-09-05 |
| Street Address |
400 S PINETREE BLVD SOUTHWESTERN STATE HOSPITAL PHARMACY |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-7128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174942684 | Department of Behavioral Health & Developmental Disabilities, Ga | General Practice | 400 S Pinetree Blvd, Thomasville, GA 31792-7128 | 2014-04-11 |
| 1427486125 | Christopher Blagg | Psychologist | 400 S Pinetree Blvd, Thomasville, GA 31792-7128 | 2013-10-16 |
| 1801238464 | Cynthia Michelle Solecki | Psychologist | 400 S Pinetree Blvd, Thomasville, GA 31792-7128 | 2013-07-24 |
| 1255675179 | James I Maish | Psychologist | 400 S Pinetree Blvd, Thomasville, GA 31792-7128 | 2012-11-15 |
| 1033491600 | Thomas Gabriel Hotard I | Dentist | 400 S Pinetree Blvd, Dental Clinic, Bldg. 510, Thomasville, GA 31792-7128 | 2011-09-09 |
| 1205166196 | William A. Trevejo | General Practice | 400 S Pinetree Blvd, Patient Billing Dept, Thomasville, GA 31792-7128 | 2009-12-28 |
| 1447482880 | Department of Behavioral Health & Developmental Disabilities | Psychiatric Hospital | 400 S Pinetree Blvd, Patient Billing Dept, Thomasville, GA 31792-7128 | 2009-08-19 |
| 1265667463 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 400 S Pinetree Blvd, Thomasville, GA 31792-7128 | 2009-05-18 |
| 1083849285 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 400 S Pinetree Blvd, Patient Billing Dept, Thomasville, GA 31792-7128 | 2009-05-18 |
| 1841416260 | Brady Lee Hudson Jr. | Psychologist | 400 S Pinetree Blvd, Bldg 414-a - Forensic Services, Thomasville, GA 31792-7128 | 2007-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740538545 | Thomasville Family Pharmacy LLC | Pharmacy | 1116 Lexington Ave, Thomasville, NC 27360-3415 | 2012-08-27 |
| 1366519555 | Thoamsville Pharmacy | Pharmacy | 702 Randolph St, Thomasville, NC 27360-5713 | 2006-11-30 |
| 1194819078 | Murphy and Cox Pharmacy Inc | Pharmacy | 616 S Broad St, Thomasville, GA 31792-5551 | 2006-10-03 |
| 1093829061 | Family Medicine Pharmacy LLC | Pharmacy | 470 Safford Ave W, Thomasville, AL 36784-3112 | 2006-08-18 |
| 1417980426 | Advanced Medical Group, LLC | Pharmacy | 816 Gordon Ave, Thomasville, GA 31792-6611 | 2006-07-10 |
| 1295784270 | Advanced Medical Group LLC | Pharmacy | 108 S Broad St, Thomasville, GA 31792-5541 | 2006-05-08 |
| 1215932082 | Chair City Pharmacy Incorporated | Pharmacy | 916 Randolph St Ste C, Thomasville, NC 27360-5729 | 2005-06-16 |
| 1871093328 | Rose City Pharmacy LLC | Pharmacy | 616 S Broad St, Thomasville, GA 31792-5551 | 2018-02-20 |
| 1568572253 | Kerr Drug Inc A Delaware Company | Pharmacy | 108 E Main St, Thomasville, NC 27360-4041 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607662 | H & W Pharmacy | Pharmacy | 4091 Redan Rd Ste C, Stone Mountain, GA 30083-4767 | 2020-10-23 |
| 1720603756 | Medical-pharmacy Associates of Georgia, LLC | Pharmacy | 1425 Georgia Ave Ste 1, Macon, GA 31201-6546 | 2020-06-16 |
| 1700419454 | Janus Rx | Pharmacy | 836 E 65th St Ste 42, Savannah, GA 31405-4496 | 2020-02-20 |
| 1295373702 | Downtown Pharmacy LLC | Pharmacy | 236 Forsyth St Sw Ste 202b, Atlanta, GA 30303-3786 | 2019-12-16 |
| 1750928719 | Goodscript, Inc. | Pharmacy | 3115 Roswell Rd Ste 205, Marietta, GA 30062-7611 | 2019-12-09 |
| 1942844741 | Genoa Healthcare, LLC | Pharmacy | 400 Technology Ct Se Ste J, Room P, Smyrna, GA 30082-5237 | 2019-11-05 |
| 1225670995 | Allcare Pharmacy, LLC | Pharmacy | 1004 S Tennille Ave, Donalsonville, GA 39845 | 2019-10-14 |
| 1417598327 | Connect Care Pharmacy, LLC | Pharmacy | 2191 Hwy 247 Connector, Byron, GA 31008-5531 | 2019-10-02 |
| 1467003467 | Selamawit Dejene | Pharmacy | 464 Bishop St Nw Apt 336, Atlanta, GA 30318-5384 | 2019-09-23 |
| 1902454721 | Batts Drug Company Mansfield, LLC | Pharmacy | 4424 Highway 213, Mansfield, GA 30055-3211 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
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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.