AU MEDICAL CENTER, INC. (NPI# 1699308114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699308114 |
| Entity Type | Organization |
| Organization Name | AU MEDICAL CENTER, INC. |
| Other Organization Name | AU MEDICAL CENTER MOORE AVENUE CLINIC PHARMACY |
| Practice Address |
1014 Moore Avenue Augusta GA 30912-0001 |
| Mailing Address |
1120 15th St # 1467 Augusta GA 30912-0004 |
| Practice Telephone | 7067210211 |
| Mailing Telephone | 7067214258 |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | ANGELA R ASHMORE (REIMBURSEMENT MANAGER) |
| Authorized Official Telephone | 7067214258 |
| Is Organization Subpart | Y |
| Parent Organization Name | AU MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| AU Medical Center Moore Avenue Clinic Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1487901476 | Au Medical Center, Inc. | Pharmacy | 1120 15th St # Bt1964, Augusta, GA 30912-0004 | 2012-08-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AU MEDICAL CENTER, INC. | 1120 15th St Fy100, Augusta, GA 30912-0004 |
| Street Address |
1014 MOORE AVENUE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| 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 |
|---|---|---|---|---|
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1891161246 | Gabiga-jordan LLC | Pharmacy | 4046 Jimmie Dyess Pkwy Ste 100, Augusta, GA 30909-9468 | 2015-08-19 |
| 1962803775 | Bryant and Newsome LLC | Pharmacy | 215 Furys Ferry Rd, Augusta, GA 30907-4718 | 2014-09-11 |
| 1073895496 | Costco Wholesale Corporation | Pharmacy | 825 Cabela Dr, Augusta, GA 30909-8202 | 2011-09-12 |
| 1467732701 | Medex Associates LLC | Pharmacy | 811 13th St Ste 10, Augusta, GA 30901-2771 | 2011-08-18 |
| 1598068967 | Clinical Specialties, LLC | Pharmacy | 318 Baston Rd, Suite 103, Augusta, GA 30907-2978 | 2010-12-07 |
| 1972789311 | Cvs State Capital LLC | Pharmacy | 119 Crossing Way, Augusta, ME 04330-6102 | 2008-01-16 |
| 1184727547 | Georgia Cvs Pharmacy LLC | Pharmacy | 2902 Peach Orchard Rd, Augusta, GA 30906-3504 | 2006-09-07 |
| 1255434072 | Georgia Cvs Pharmacy LLC | Pharmacy | 2559 Windsor Spring Rd, Augusta, GA 30906-4642 | 2006-09-07 |
| 1881639706 | Walgreen Co | Pharmacy | 3228 Wrightsboro Rd, Augusta, GA 30909-2937 | 2006-06-17 |
| Find all providers in AUGUSTA | ||||
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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.