MARCUS LEE HEDRICK (NPI# 1861091779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861091779 |
| Entity Type | Individual |
| Full Name | MARCUS LEE HEDRICK |
| Credential | PHARMACIST |
| Practice Address |
3240 S Cobb Dr Se Smyrna GA 30080-4194 |
| Mailing Address |
961 Durrell St Austell GA 30106-1405 |
| Practice Telephone | 7704333420 |
| Mailing Telephone | 6783891841 |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | GA017240 | GA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA EPH LOS ENSE | GA017240 | 01 |
| Street Address |
3240 S COBB DR SE |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-4194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609952688 | Johnetta Gigi Thompson | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2006-10-31 |
| 1659979524 | Min Yi Lee | Pharmacist | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2020-10-13 |
| 1215548003 | Selina Fambro | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2020-08-13 |
| 1578185146 | Benjamin Sherrill | Pharmacist | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2020-05-17 |
| 1821629429 | Areum Han | Pharmacist | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2020-02-01 |
| 1740845635 | Mariagorrathy Nkiru Ejike | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080 | 2019-05-06 |
| 1548778988 | Amanda Pyatt Knowles | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2018-01-19 |
| 1790298222 | Angelique Letrell Pack | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2017-11-07 |
| 1427593326 | Guatemala Kimble | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2016-12-31 |
| 1356893341 | National Vision, Inc. | Technician/Technologist | 3240 S Cobb Dr Se, Ste 1000, Smyrna, GA 30080-4194 | 2016-10-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| 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 |
|---|---|---|---|---|
| 1528628252 | Amy J Campbell | Pharmacist | 133 Bordeaux Ct, Smyrna, TN 37167-4606 | 2019-06-14 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1518483171 | Yvener Charles | Pharmacist | 969 Windy Hill Rd Se Ste A, Smyrna, GA 30080-2025 | 2017-08-16 |
| 1497271282 | Elizabeth Lai | Pharmacist | 3253 Polo Run Cir Se, Smyrna, GA 30082-2454 | 2017-08-14 |
| 1043759988 | Roxanne Musharrafeia | Pharmacist | 4003 Saint Jules Way, Smyrna, TN 37167-7562 | 2017-02-13 |
| 1316494420 | Elizabeth Daniel | Pharmacist | 3250 Millwood Trl Se, Smyrna, GA 30080-1602 | 2016-09-07 |
| 1629450606 | Tzu-wei Huang | Pharmacist | 3303 Fieldwood Dr Se, Smyrna, GA 30080-1611 | 2015-06-25 |
| 1629486436 | Vickie Andros | Pharmacist | 200 Technology Ct Se Ste B, Smyrna, GA 30082-5201 | 2014-07-24 |
| 1144568536 | Jacinta E Jackson | Pharmacist | 2148 S Cobb Dr Se, Smyrna, GA 30080-1348 | 2013-01-21 |
| 1710224662 | Brandi Fannon | Pharmacist | 1950 Lake Park Dr Se, Smyrna, GA 30080-7648 | 2013-01-12 |
| Find all providers in SMYRNA | ||||
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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.