NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC (NPI# 1609127778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609127778 |
| Entity Type | Organization |
| Organization Name | NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC |
| Other Organization Name | NSH CIPS G |
| Practice Address |
4586 Timber Ridge Dr Suite 200 Douglasville GA 30135-7517 |
| Mailing Address |
1835 Savoy Dr Suite 300 Atlanta GA 30341-1072 |
| Practice Telephone | 7708420457 |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2014-05-12 |
| Authorized Official Name | JORGE J HERNANDEZ (VP OF ADMIN SERVICES AND CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHSIDE HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| NSH CIPS G | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891046967 | Nsh Cancer Institute Professional Services G, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cowles Clinc Way, Magnolia Building, Suite M-200, Greensboro, GA 30642-5285 | 2012-09-28 |
| 1124379284 | Nsh Cancer Institute Professional Services G, LLC | Pharmacy | 1100 Johnson Ferry Rd Ne, Suite 600, Atlanta, GA 30342-1709 | 2012-09-28 |
| 1932450004 | Nsh Cancer Institute Professional Services G, LLC | Durable Medical Equipment & Medical Supplies | 1501 Milstead Rd Ne, Suite 110, Conyers, GA 30012-3838 | 2012-09-28 |
| 1649521717 | Nsh Cancer Institute Professional Services G, LLC | Durable Medical Equipment & Medical Supplies | 7823 Spivey Station Blvd, Suite 300, Jonesboro, GA 30236-2886 | 2012-09-28 |
| 1699026831 | Nsh Cancer Institute Professional Services G, LLC | Pharmacy | 1100 Johnson Ferry Rd Ne, Suite 600, Atlanta, GA 30342-1709 | 2012-09-27 |
| 1144571381 | Nsh Cancer Institute Professional Services G, LLC | Pharmacy | 1100 Johnson Ferry Rd Ne, Suite 600, Sandy Springs, GA 30342-1709 | 2012-09-27 |
| Street Address |
4586 TIMBER RIDGE DR SUITE 200 |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30135-7517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922086610 | Deepti A Munjal | Internal Medicine | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135-7517 | 2006-01-04 |
| 1427506948 | Mesha Mainor | Physical Therapist | 4586 Timber Ridge Dr, Douglasville, GA 30135-7517 | 2016-09-13 |
| 1255888236 | Julianna L. Rock | Pharmacist | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135-7517 | 2016-09-07 |
| 1164720090 | Jennifer Jordan Dawe | Nurse Practitioner | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135-7517 | 2011-03-01 |
| 1831361922 | Kristen A. Peyton | Specialist/Technologist | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135-7517 | 2008-03-28 |
| 1235356759 | Kristy G. Mcdonald-grimm | Internal Medicine | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135 | 2007-04-18 |
| 1548300452 | Douglas Neurology Associates, P.C. | Psychiatry & Neurology | 4586 Timber Ridge Dr, Suite 140, Douglasville, GA 30135-7517 | 2007-02-08 |
| 1295799948 | John P. Copeland Jr. | Physical Therapist | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135-7517 | 2006-04-12 |
| 1699739359 | Jeffrey M. Goldberg | Physical Therapist | 4586 Timber Ridge Dr, Suite 200, Douglasville, GA 30135-7517 | 2006-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043301 | Heart & Soul Wellness Solutions LLC | Social Worker | 4752 Pepper Tree Lane, Douglasville, GA 30135 | 2020-08-12 |
| 1477176923 | R & J Health Care | Clinic/Center | 6853b Douglas Blvd Ste B, Douglasville, GA 30135 | 2020-05-19 |
| 1003479411 | The Sister Circle of Love and Empowerment LLC | Clinic/Center | 4706 Boyer Glen Dr., Douglasville, GA 30135 | 2019-04-22 |
| 1457825358 | Marcia Ann-marie Wilson | Nurse Practitioner | 4279 Caroline Court, Douglasville, GA 30135 | 2019-01-14 |
| 1225564917 | Danielle Doebereiner-brown | Nurse Practitioner | 3872 Ga-5, Douglasville, GA 30135 | 2017-05-02 |
| 1851832430 | Jennifer Williams | Physical Therapist | 4999 Presley Mill Rd, Douglasville, GA 30135 | 2017-03-15 |
| 1316484686 | Geneva Brent | Licensed Practical Nurse | 2109 Fairburn Road, Douglasville, GA 30135 | 2017-01-25 |
| 1659816288 | Stephanie Walthour | Marriage & Family Therapist | 3400 Chapel Hill Rd Ste 317, Douglasville, GA 30135 | 2017-01-05 |
| 1770932105 | Solutions 2 Wellness and Recovery,llc | Social Worker | 2256 Greenwood Meadows Lane, Douglasville, GA 30135 | 2016-06-07 |
| 1326408378 | Sr & L Transport Services, LLC | Non-emergency Medical Transport (VAN) | 4841 Black Bear Trail, Douglasville, GA 30135 | 2016-03-03 |
| Find all providers in zip 30135 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922522002 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2710 Fairburn Rd, Douglasville, GA 30135-2942 | 2017-07-31 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1720467715 | Sean Todd-crooks | Durable Medical Equipment & Medical Supplies | 3881 Erica Cir, Douglasville, GA 30135-4117 | 2015-05-22 |
| 1730443094 | Empirical Medical Equipment Inc. | Durable Medical Equipment & Medical Supplies | 8318 Duralee Ln Ste 204, Douglasville, GA 30134 | 2012-07-01 |
| 1811256605 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3674 Highway 5, Douglasville, GA 30135-2364 | 2012-05-14 |
| 1518286202 | Epw Enterprise LLC | Durable Medical Equipment & Medical Supplies | 3686 Lower Creek Dr, Douglasville, GA 30135-4291 | 2010-05-20 |
| 1326282567 | Kay One Source LLC | Durable Medical Equipment & Medical Supplies | 1911 David Dr, Douglasville, GA 30135-6824 | 2009-04-30 |
| 1053565812 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2701 Fairburn Rd, Douglasville, GA 30135-2941 | 2008-11-06 |
| 1023266921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3851 Chapel Hill Rd, Douglasville, GA 30135-7287 | 2008-09-04 |
| 1164682563 | Magalie Guerrier | Durable Medical Equipment & Medical Supplies | 133 Carrington Ln, Douglasville, GA 30135 | 2008-06-10 |
| Find all providers in DOUGLASVILLE | ||||
| City | DOUGLASVILLE |
| Zip Code | 30135 |
Please comment or provide details below to improve the information on NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC.
| 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.