MAYO CLINIC HEALTH SYSTEM IN WAYCROSS (NPI# 1831393107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831393107 |
| Entity Type | Organization |
| Organization Name | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS |
| Other Organization Name | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS |
| Practice Address |
1900 Tebeau Street Waycross GA 31501-5246 |
| Practice Telephone | 9122872640 |
| Mailing Telephone | 9122872640 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2012-05-22 |
| Authorized Official Name | MR. BENJAMIN RANDOLPH WHEELER (DIRECTOR OF PHARMACY) |
| Authorized Official Telephone | 9122872506 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
PHRE005914 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | NCPDP | 1155476 | 01 |
| GA | MEDCO | 108000306 | 01 |
| DEA REGISTRATION | BM2658372 | 01 | |
| GA | PHARMACY LICENSE | PHRE005914 | 01 |
| Other Name | Type Code |
|---|---|
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | Other Name - Individual/Organization |
| Street Address |
1900 TEBEAU STREET |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-5246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558334334 | Mayo Clinic Health System In Waycross, Inc | General Acute Care Hospital | 1900 Tebeau Street, Waycross, GA 31501 | 2006-02-10 |
| 1548652449 | Tammie Rowe | Dietitian, Registered | 1900 Tebeau Street, Waycross, GA 31501 | 2015-03-02 |
| 1700278868 | Kelli Alford | Dietitian, Registered | 1900 Tebeau Street, Waycross, GA 31501 | 2015-02-26 |
| 1841434255 | James R. Kisselburg | Hospitalist | 1900 Tebeau Street, Waycross, GA 31501 | 2009-04-29 |
| 1285796839 | Mayo Clinic Health System In Waycross, Inc. | Psychiatric Unit | 1900 Tebeau Street, Waycross, GA 31501 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; 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 |
|---|---|---|---|---|
| 1932690922 | Middle Georgia Correctional Complex Pharmacy | Pharmacy | 2271 Vinson Hwy Se, Milledgeville, GA 31061-4807 | 2018-05-24 |
| 1316438393 | Macon State Prison Regional Pharmacy | Pharmacy | 2728 Ga Highway 49 S, Oglethorpe, GA 31068-8129 | 2018-05-24 |
| 1851882013 | Lee Arrendale State Prison Pharmacy | Pharmacy | 2023a Gainesville Hwy, Alto, GA 30510-4435 | 2018-05-23 |
| 1831689728 | Autry State Prison Pharmacy | Pharmacy | 3178 Mount Zion Church Rd, Pelham, GA 31779 | 2018-05-16 |
| 1003939794 | Nw Ga Regional Hospital | Pharmacy | 705 N Division St Nw, Rome, GA 30165-1454 | 2007-04-09 |
| 1861505430 | Department of Behavioral Health and Developmental Disabilities | Pharmacy | 325 Lawrence Rd, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-16 |
| 1689165482 | Georgia Diagnostic & Classification Prison Pharmacy | Pharmacy | 2978 Highway 36 W, Jackson, GA 30233-6150 | 2018-05-29 |
| 1902397995 | Pulaski State Prison Regional Pharmacy | Pharmacy | 373 Upper River Rd, Hawkinsville, GA 31036-8898 | 2018-05-24 |
| 1184115321 | Georgia State Prison Regional Pharmacy | Pharmacy | 300 1st Ave S, Reidsville, GA 30453-9304 | 2018-05-23 |
| 1972094134 | Valdosta State Prison Regional Pharmacy | Pharmacy | 3259 Val Tech Rd, Valdosta, GA 31602-9309 | 2018-05-23 |
| 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.