WEST JACKSON MEDICINE CENTER, INC (NPI# 1790846426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790846426 |
| Entity Type | Organization |
| Organization Name | WEST JACKSON MEDICINE CENTER, INC |
| Practice Address |
3845 Hwy 53 Hoschton GA 30548 |
| Mailing Address |
3845 Highway 53 P.o. Box 271 Hoschton GA 30548 |
| Practice Telephone | 7066543690 |
| Practice Fax Number | 7066541238 |
| Mailing Telephone | 7066543690 |
| Mailing Fax Number | 7066541238 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2009-05-05 |
| Authorized Official Name | MS. TRACY L JORDAN (OWNER PHARMACIST) |
| Authorized Official Telephone | 7066543690 |
| Authorized Official Credential | R.PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 005816 | GA | Suppliers |
| N | 333600000X | Pharmacy | 005816 | GA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000230238A | 05 |
| Street Address |
3845 HWY 53 |
| City | HOSCHTON |
| State | GA |
| Zip Code | 30548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386108587 | Lan Tran Schlecht | Social Worker | 255 Lamar Ln, Hoschton, GA 30548 | 2019-01-22 |
| 1265932560 | Carley Costner | Chiropractor | 280 Cambridge Farms Dr, Hoschton, GA 30548 | 2018-02-14 |
| 1285906263 | Loving Hearts Helping Hands Senior Homecare | Home Health | 2011 Maddox Road, Hoschton, GA 30548 | 2012-02-06 |
| 1588967376 | Pamela Ann Reagin | Massage Therapist | 4397 Hwy 53, Hoschton, GA 30548 | 2010-12-16 |
| 1144523176 | David Chandler Bell | Chiropractor | 55 Freedom Parkway, Suite 112, Hoschton, GA 30548 | 2010-12-14 |
| 1275781361 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 5848 Hwy 124 West, Hoschton, GA 30548 | 2008-09-03 |
| 1972635407 | Cognitive Behavioral Health LLC | Counselor | 5415 Thompson Mill Road Ste B, Dr Devin Vicknair, Hoschton, GA 30548 | 2007-03-10 |
| 1336203454 | Robert Lee Cornett | Physical Therapist | 5415 Thompson Mill Road, Hoschton, GA 30548 | 2006-12-21 |
| 1235140773 | Jennifer Hawk Wiley | Chiropractor | 117 Bell Avenue, Hoschton, GA 30548 | 2006-08-10 |
| 1992360812 | Cristen Walker | Physical Therapy Assistant | 5373 Thompson Mill Rd, Hoschton, GA 30548 | 2019-05-06 |
| Find all providers in zip 30548 | ||||
| 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] |
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| 1184225526 | Svdp Georgia Community Pharmacy LLC | Pharmacy | 2050 Chamblee Tucker Rd Ste C, Chamblee, GA 30341-3343 | 2020-11-03 |
| 1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
| 1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
| 1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
| 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.