DACULA MEDICINE CENTER (NPI# 1780761601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780761601 |
| Entity Type | Organization |
| Organization Name | DACULA MEDICINE CENTER |
| Other Organization Name | DACULA PHARMACY |
| Practice Address |
2555 2nd Avenue North Dacula GA 30019-0016 |
| Mailing Address |
Po Box 927 Dacula GA 30019-0016 |
| Practice Telephone | 7703391593 |
| Practice Fax Number | 7703391682 |
| Mailing Telephone | 7703391593 |
| Mailing Fax Number | 7703391682 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BILLY M STONE (PHARMACIST/OWNER) |
| Authorized Official Telephone | 7703391593 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 14587 | GA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | NATIONAL BOARD OF PHARMAC | 1136692 | 01 |
| Other Name | Type Code |
|---|---|
| Dacula Pharmacy | Doing Business As Name - Organization |
| Street Address |
2555 2ND AVENUE NORTH |
| City | DACULA |
| State | GA |
| Zip Code | 30019-0016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| 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 |
|---|---|---|---|---|
| 1861093155 | Mohamed J Bah | Pharmacist | 2965 Olivine Dr, Dacula, GA 30019-7646 | 2020-11-04 |
| 1932707692 | David Scott | Pharmacist | 1012 Apalachee Run Trl, Dacula, GA 30019-6703 | 2020-10-15 |
| 1326338443 | Tammy L Carloss | Pharmacist | 2580 Winder Hwy, Dacula, GA 30019-1328 | 2011-04-11 |
| 1437757804 | Krista Jeriann Parks | Pharmacist | 2700 Braselton Hwy, Dacula, GA 30019-3262 | 2020-10-16 |
| 1871191395 | Lucinda A Dixon | Pharmacist | 505 Dacula Rd, Dacula, GA 30019-2125 | 2020-10-16 |
| 1154931483 | Andrew David Mote | Pharmacist | 2463 Hamilton Mill Pkwy, Dacula, GA 30019-4648 | 2020-08-02 |
| 1558848077 | Amreen Jivani | Pharmacist | 3027 Jim Moore Rd, Dacula, GA 30019-1144 | 2018-07-26 |
| 1033607619 | Alina Lavinia Vlasin-morariu | Pharmacist | 720 Dacula Rd, Dacula, GA 30019-7055 | 2018-04-28 |
| 1174020499 | Youn Jeoung | Pharmacist | 2463 Hamilton Mill Pkwy, Dacula, GA 30019-4648 | 2018-04-12 |
| 1891241576 | Carson Simpson | Pharmacist | 720 Dacula Rd, Dacula, GA 30019-7055 | 2016-08-31 |
| Find all providers in DACULA | ||||
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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.