PRESBYTERIAN VILLAGE AUSTELL INC (NPI# 1396876793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396876793 |
| Entity Type | Organization |
| Organization Name | PRESBYTERIAN VILLAGE AUSTELL INC |
| Other Organization Name | PRESBYTERIAN VILLAGE PHARMACY |
| Practice Address |
2000 E West Connector Attn: Pharmacy Austell GA 30106-1194 |
| Practice Telephone | 7708197001 |
| Practice Fax Number | 7708197494 |
| Mailing Telephone | 7708197001 |
| Mailing Fax Number | 7708197494 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-04-19 |
| Authorized Official Name | CHARLES CORDARO (DIR OF PHCY) |
| Authorized Official Telephone | 7708197001 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PHRE009068 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2017513 | 01 | |
| GA | 666876218A | 05 |
| Other Name | Type Code |
|---|---|
| PRESBYTERIAN VILLAGE PHARMACY | Doing Business As Name - Organization |
| Street Address |
2000 E WEST CONNECTOR ATTN: PHARMACY |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952303455 | Leisa L Marshall | Pharmacist | 2000 E West Connector, Austell, GA 30106-1194 | 2005-08-15 |
| 1447811302 | Sylvia Joyce Naughton | Occupational Therapy Assistant | 2000 E West Connector, Austell, GA 30106-1194 | 2019-06-21 |
| 1245798453 | Pooja Patel | Occupational Therapist | 2000 E West Connector, Austell, GA 30106-1194 | 2019-03-06 |
| 1639635311 | Doreen Burnette | Physical Therapy Assistant | 2000 E West Connector, Austell, GA 30106-1194 | 2019-02-18 |
| 1477025518 | George Whitfield Wannamaker | Physical Therapist | 2000 E West Connector, Austell, GA 30106-1194 | 2018-12-31 |
| 1700358819 | Joseph York | Physical Therapy Assistant | 2000 E West Connector, Austell, GA 30106-1194 | 2018-12-31 |
| 1225500325 | Christine Theresa Cesta | Occupational Therapy Assistant | 2000 E West Connector, Austell, GA 30106-1194 | 2018-12-30 |
| 1174095244 | Ashley Moore | Physical Therapy Assistant | 2000 E West Connector, Austell, GA 30106-1194 | 2018-12-29 |
| 1548732621 | Lily Loretta Stevens | Occupational Therapy Assistant | 2000 E West Connector, Austell, GA 30106-1194 | 2018-12-29 |
| 1447356282 | Yolanda H Montague | Pharmacist | 2000 E West Connector, Austell, GA 30106-1194 | 2006-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| 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] |
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| 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 | ||||
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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.