BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA (NPI# 1679647473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679647473 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA |
| Other Organization Name | TIFT PHARMACY |
| Practice Address |
334 Tifton Eldorado Rd Tifton GA 31794-9497 |
| Practice Telephone | 2293912300 |
| Practice Fax Number | 2293867400 |
| Mailing Telephone | 2293912280 |
| Mailing Fax Number | 2293867400 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-06-18 |
| Authorized Official Name | MR. WILLIAM F HULING (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2296716140 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Mental Health Center Pharmacy | Doing Business As Name - Organization |
| Tift Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831671973 | Behavioral Health Services of South Georgia | Clinic/Center | 201 W Mcpherson Ave, Nashville, GA 31639-2131 | 2018-09-05 |
| 1528132321 | Behavioral Health Services of South Georgia | Community Based Residential Treatment Facility, Mental Illness | 1 Dellwood Cir, Valdosta, GA 31602-2335 | 2006-11-20 |
| 1083787287 | Behavioral Health Services of South Georgia | Clinic/Center | 507 Laurel St, Nashville, GA 31639-2555 | 2006-11-16 |
| 1912986282 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Suite C, Valdosta, GA 31602-1007 | 2006-01-13 |
| 1255875910 | Behavioral Health Services of South Georgia | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-12-14 |
| 1083754535 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 | 2007-02-07 |
| 1639219181 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 | 2007-02-07 |
| 1881734333 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Valdosta, GA 31602-1007 | 2007-02-07 |
| 1801932371 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Suite C, Valdosta, GA 31602-1007 | 2007-01-30 |
| 1588739601 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2006-11-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 |
| Street Address |
334 TIFTON ELDORADO RD |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-9497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558457655 | South Georgia Csb | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2006-10-05 |
| 1043844418 | Amanda L Cofield | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2020-02-25 |
| 1124674767 | Robin Meadows | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2019-08-09 |
| 1487219770 | Nyesia Knight | Counselor | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2019-05-02 |
| 1275090086 | Daniel Jason Spratlin | Social Worker | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2019-02-28 |
| 1487146932 | Norma Ann Chin | Counselor | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2018-05-31 |
| 1235621897 | Jodi Evans Lott | Nurse Practitioner | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2018-05-30 |
| 1760929228 | Tyundreya Lindsey | Marriage & Family Therapist | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2017-01-23 |
| 1255875910 | Behavioral Health Services of South Georgia | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-12-14 |
| 1265976435 | Davina G Samuel | Counselor | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1124598362 | Grady Memorial Hospital Corporation | Pharmacy | 80 Jesse Hill Jr Dr Se Rm 10b-043, Atlanta, GA 30303-3031 | 2018-11-30 |
| 1265974455 | Counseling Solutions of Chatsworth, LLC | Pharmacy | 1289 Gi Maddox Pkwy, Chatsworth, GA 30705-2069 | 2016-11-05 |
| 1912367111 | Carrollton Orthopaedic Clinic PC | Pharmacy | 812 S Park St Ste 3, Carrollton, GA 30117-4412 | 2016-03-01 |
| 1013376490 | Carrollton Orthopaedic Clinic PC | Pharmacy | 204 Allen Memorial Dr Ste 102, Bremen, GA 30110-2063 | 2016-02-15 |
| 1861791246 | New Start Treatment, LLC | Pharmacy | 1615 Highway 19 N, User, Thomaston, GA 30286-2277 | 2011-03-24 |
| 1740584770 | Southcoast Medical Group P C | Pharmacy | 1326 Eisenhower Dr Bldg 1, Savannah, GA 31406-3928 | 2011-01-05 |
| 1235348020 | Medicine Center of Atlanta | Pharmacy | 3646 Chamblee Tucker Rd, Suite C, Chamblee, GA 30341-4406 | 2007-05-21 |
| 1700099454 | Curtis V. Cooper Primary Health Care, Inc. | Pharmacy | 106 E. Broad St., Savannah, GA 31401-2917 | 2007-05-08 |
| 1720187602 | Forest Heights Phcy Inc | Pharmacy | Hlth Svcs Bldg, Watson Hall, Statesboro, GA 30460-0001 | 2006-09-21 |
| 1811902448 | Middle Flint Community Board | Pharmacy | 1335 N 5th Street Ext, Cordele, GA 31015-3753 | 2006-07-30 |
| 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.