MARY FREDERICK (NPI# 1780036624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780036624 |
| Entity Type | Individual |
| Full Name | MARY FREDERICK |
| Practice Address |
1108 E 1st St Vidalia GA 30474-4206 |
| Practice Telephone | 9125380311 |
| Mailing Telephone | 9125380311 |
| Enumeration Date | 2016-07-04 |
| Last Update Date | 2016-07-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH029177 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437133485 | Mary A Frederick | Internal Medicine | 1316 Broadway Se, Albuquerque, NM 87102 | 2005-12-02 |
| 1669958146 | Mary Grace Frederick | Technician/Technologist | 32100 Telegraph Rd Ste 205, Bingham Farms, MI 48025-2454 | 2018-07-17 |
| 1215341045 | Mary Elizabeth Frederick | Nurse Practitioner | 2449 Old Fort Pkwy, Murfreesboro, TN 37128-4162 | 2014-06-19 |
| 1326045972 | Mary Gena Frederick | Radiology | 1025 Medical Center Dr, Delaney Radiologists Group, Pllc, Wilmington, NC 28401 | 2005-06-28 |
| Street Address |
1108 E 1ST ST |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457874034 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1108 E 1st St, Vidalia, GA 30474-4206 | 2017-07-25 |
| 1992004048 | John Peery | Pharmacist | 1108 E 1st St, Vidalia, GA 30474-4206 | 2011-03-15 |
| 1700184371 | Rohit Govindbhai Patel | Pharmacist | 1108 E 1st St, Vidalia, GA 30474-4206 | 2011-03-07 |
| 1760506638 | Jennifer Lynn Corley | Pharmacist | 1108 E 1st St, Vidalia, GA 30474-4206 | 2007-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655374 | Abby Virginia Adams | Speech-Language Pathologist | 101 Harris Insustrial Blvd, Vidalia, GA 30474 | 2018-10-22 |
| 1467930156 | Laurel Shiver Sapp | Nurse Practitioner | 1608 Meadows Ln, Vidalia, GA 30474 | 2018-08-03 |
| 1235658931 | Mary Frances Andrews | Nurse Practitioner | 1608 Meadows Lane Suite 1, Vidalia, GA 30474 | 2017-09-13 |
| 1154714574 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 104 Andrews Street, Suite 112, Vidalia, GA 30474 | 2015-03-10 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1801235312 | Paul Anderson Youth Home, Inc. | Substance Abuse Rehabilitation Facility | 1603 Mcintosh Street, Vidalia, GA 30474 | 2013-06-18 |
| 1043591076 | Kimberly Thigpen Evans | Nurse Practitioner | 621 East First Street, Unit B, Vidalia, GA 30474 | 2011-09-03 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1255586053 | Vidalia Medical Partners Inc. | Home Health | 801 Mcnatt Street, Vidalia, GA 30474 | 2008-11-20 |
| 1154596419 | Jill Nicole Lawrence | Speech-Language Pathologist | 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 | 2008-04-28 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174945042 | Willene Hodges | Pharmacist | 1704 Aimwell Rd, Vidalia, GA 30474-9001 | 2014-01-13 |
| 1295089126 | Ricky Allen Mcintyre | Pharmacist | 1527 Orange St, Vidalia, GA 30474-5916 | 2012-10-30 |
| 1891922803 | Larry James Mcmanus | Pharmacist | 1015 Alabama St, Vidalia, LA 71373-2612 | 2009-06-17 |
| 1508965138 | George Lindsey Hodges | Pharmacist | 305 Maple Dr, Vidalia, GA 30474-8908 | 2006-09-21 |
| 1588683445 | Chapman Healthcare Pharmacy Inc | Pharmacist | 305 Maple Dr., Vidalia, GA 30474-8908 | 2006-07-19 |
| 1114527579 | Brendan Darby Pearsall | Pharmacist | 3109 E 1st St, Vidalia, GA 30474-8830 | 2020-10-27 |
| 1013550086 | Amanda Claire Clark | Pharmacist | 305 Maple Dr, Vidalia, GA 30474-8908 | 2019-10-23 |
| 1659912590 | Carlis Mckenley Hand Jr. | Pharmacist | 3109 E 1st St, Vidalia, GA 30474-8830 | 2019-10-02 |
| 1952881179 | Annilyne Michele Phillips | Pharmacist | 3109 E 1st St, Vidalia, GA 30474-8830 | 2018-08-16 |
| 1598217952 | Darla Dunbar | Pharmacist | 4283 Carter St, Vidalia, LA 71373-3148 | 2016-11-01 |
| Find all providers in VIDALIA | ||||
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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.