ADVANCED MEDICAL GROUP, LLC (NPI# 1679811731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679811731 |
| Entity Type | Organization |
| Organization Name | ADVANCED MEDICAL GROUP, LLC |
| Other Organization Name | THOMAS DRUG STORE |
| Practice Address |
118 N Main St Boston GA 31626-2257 |
| Mailing Address |
450 Old Peachtree Rd Nw Suite 102 Suwanee GA 30024-7289 |
| Practice Telephone | 2294981018 |
| Practice Fax Number | 2294981012 |
| Mailing Telephone | 8776453506 |
| Mailing Fax Number | 6786891459 |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-29 |
| Authorized Official Name | MR. VANCE T WALL SR. (CEO/PRESIDENT) |
| Authorized Official Telephone | 8776453506 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PHRE009897 | GA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE009897 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RETAIL PHARMACY PERMIT | PHRE009897 | 01 |
| Other Name | Type Code |
|---|---|
| THOMAS DRUG STORE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912304197 | Advanced Medical Group, LLC | Durable Medical Equipment & Medical Supplies | 839 Richland Ave W, Aiken, SC 29801-3833 | 2014-12-03 |
| 1972866572 | Advanced Medical Group, LLC | Internal Medicine | 1390 Nw. 7 - Street, Miami, FL 33125 | 2012-06-19 |
| 1003087685 | Advanced Medical Group, LLC | Pharmacy | 450 Old Peachtree Rd Nw, Suite 102, Suwanee, GA 30024-7289 | 2008-03-21 |
| 1417980426 | Advanced Medical Group, LLC | Pharmacy | 816 Gordon Ave, Thomasville, GA 31792-6611 | 2006-07-10 |
| 1134554538 | Advanced Medical Group, LLC | Radiology | 311 N Keene St, Columbia, MO 65201-6623 | 2013-09-05 |
| Street Address |
118 N MAIN ST |
| City | BOSTON |
| State | GA |
| Zip Code | 31626-2257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851636070 | Boston Family Care Clinic, LLC | Clinic/Center | 118 N Main St, Boston, GA 31626-2257 | 2012-11-28 |
| 1407981434 | Rj Griffis Enterptises LLC | Pharmacy | 118 N Main St, Boston, GA 31626-2257 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003223637 | Peace On Earth, LLC | Home Health | 212 Taylor Street, Boston, GA 31626 | 2014-07-15 |
| 1285945469 | Precious Ones Personal Care Home Inc. | Durable Medical Equipment & Medical Supplies | 20944 Us Hwy 84 East, Precious Ones Personal Care Home Inc., Boston, GA 31626 | 2010-06-23 |
| 1205057551 | Brooks County Hospital | Family Medicine | 118 North Main Street, Boston, GA 31626 | 2007-05-02 |
| 1114585940 | Jessica Paige Oliver | Nurse Practitioner | 2557 State Line Rd, Boston, GA 31626-2441 | 2019-06-05 |
| 1508858556 | Bassha Yancey Walker | Speech-Language Pathologist | 22249 Us Highway 84 E, Boston, GA 31626-3745 | 2005-08-16 |
| 1437463940 | Thomasville Pediatric Speech, LLC | Speech-Language Pathologist | 22249 Us Highway 84 E, Boston, GA 31626-3745 | 2010-07-27 |
| 1548874985 | Dana Tindell | Occupational Therapist | 7792 Coffee Rd, Boston, GA 31626-3945 | 2020-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568955 | Melanie Hanson | Social Worker | 47 West St Fl 4, Boston, MA 02111-1219 | 2020-11-03 |
| 1568063865 | Tenderrose Health Care LLC | Home Health | 1076 Washington St, Boston, MA 02124-5520 | 2020-11-03 |
| 1306447636 | Sarah Wieman | Student in an Organized Health Care Education/Training Program | 16 Blossom St Fl 1, Boston, MA 02114-3104 | 2020-11-03 |
| 1518568880 | Regina To | Acupuncturist | 2 Sterling Sq Apt 908, Boston, MA 02127-3613 | 2020-11-03 |
| 1376144899 | Christine Keywan | Genetic Counselor, MS | 320 D St Unit 451, Boston, MA 02127-1284 | 2020-11-02 |
| 1700486693 | Mark Comstock | Specialist/Technologist | 74 Union Park St, Boston, MA 02118-2142 | 2020-10-29 |
| 1063012243 | Megan Alicia Harty | Developmental Therapist | 183 I St, Boston, MA 02127-4049 | 2020-10-28 |
| 1932709938 | Brianna Mae Duval | Student in an Organized Health Care Education/Training Program | 58 Colborne Rd, Boston, MA 02135-4103 | 2020-10-28 |
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1407455264 | Jennifer Anne Espinal | Behavioral Analyst | 418 Centre St, Boston, MA 02130-5197 | 2020-10-22 |
| Find all providers in BOSTON | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1356990931 | Capsule Pharmacy Boston LLC | Pharmacy | 414 Boylston St, Boston, MA 02116-3801 | 2019-09-06 |
| 1336635614 | Bidmc Pharmacy, Inc. | Pharmacy | 364 Brookline Ave, Boston, MA 02215-5401 | 2018-07-10 |
| 1699154427 | Sun Health Systems | Pharmacy | 3158 Washington St, Boston, MA 02130-4514 | 2015-05-26 |
| 1659790442 | Walgreen Co | Pharmacy | 75 Amory St Ste 100, Boston, MA 02119-1051 | 2014-04-09 |
| 1740615574 | Galaxy Pharmacy LLC | Pharmacy | 534 Dorchester Ave Unit C-1, Boston, MA 02127-2762 | 2013-09-11 |
| 1013340884 | Vietaz Inc | Pharmacy | 2288 Dorchester Ave, Boston, MA 02124-5622 | 2013-08-15 |
| 1760828149 | Blue Hill Pharmacy LLC | Pharmacy | 320 Blue Hill Ave, Boston, MA 02121-1951 | 2013-05-13 |
| 1083849525 | Daisys Pharmacy Corp | Pharmacy | 1670 Commonwealth Ave, Boston, MA 02135-5601 | 2009-05-28 |
| 1437219466 | Giangregorio Bros Inc. | Pharmacy | 393 Hanover St, Boston, MA 02113-1308 | 2006-12-11 |
| 1659470003 | Cvs Pharmacy Inc | Pharmacy | 55 Summer St, Boston, MA 02110-1007 | 2006-09-22 |
| Find all providers in BOSTON | ||||
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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.