CLAYTON MHDDAD (NPI# 1861700973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861700973 |
| Entity Type | Organization |
| Organization Name | CLAYTON MHDDAD |
| Other Organization Name | CLAYTON CSB |
| Practice Address |
1585 Pintail Rd Jonesboro GA 30238-6641 |
| Mailing Address |
112 Broad St Jonesboro GA 30236-3563 |
| Practice Telephone | 7704782280 |
| Mailing Telephone | 7704782280 |
| Mailing Fax Number | 7704779772 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |
| Authorized Official Name | MR. TERRY COLE (CEO) |
| Authorized Official Telephone | 7704782280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00606922AQ | 05 |
| Other Name | Type Code |
|---|---|
| Clayton CSB | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518113869 | Clayton Mhddad | Community/Behavioral Health | 1044 Pinecrest Dr, Forest Park, GA 30297-3335 | 2008-08-18 |
| 1427204775 | Clayton Mhddad | Community/Behavioral Health | 6278 Holiday Blvd, Forest Park, GA 30297-4262 | 2008-08-18 |
| 1386890341 | Clayton Mhddad | Community/Behavioral Health | 6944 Fielder Rd, Rex, GA 30273-2414 | 2008-08-11 |
| 1104082866 | Clayton Mhddad | Community/Behavioral Health | 269 Valley Hill Rd Sw, Riverdale, GA 30274-2745 | 2008-08-01 |
| 1639358906 | Clayton Mhddad | Clinic/Center | 1585 Pintail Rd, Jonesboro, GA 30238-6641 | 2007-11-02 |
| 1679761373 | Clayton Mhddad | Clinic/Center | 2081 Logan Dr, Jonesboro, GA 30236-7215 | 2007-10-09 |
| 1942498647 | Clayton Mhddad | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5800 Lillian Ln, Morrow, GA 30260-3965 | 2007-10-09 |
| 1851589550 | Clayton Mhddad | Clinic/Center | 7814 Fielder Rd, Jonesboro, GA 30236-2610 | 2007-10-09 |
| 1588852289 | Clayton Mhddad | Clinic/Center | 5818 Thompson Blvd, Morrow, GA 30260-3910 | 2007-10-09 |
| 1497943104 | Clayton Mhddad | Clinic/Center | 901 Walnut Creek Ln, Jonesboro, GA 30238-6465 | 2007-10-09 |
| Street Address |
1585 PINTAIL RD |
| City | JONESBORO |
| State | GA |
| Zip Code | 30238-6641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639358906 | Clayton Mhddad | Clinic/Center | 1585 Pintail Rd, Jonesboro, GA 30238-6641 | 2007-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366969636 | K&p Gentle Hnads Homecare | Home Health | 772 Pointe South Pkwy, Apt. 501, Jonesboro, GA 30238 | 2017-08-27 |
| 1568991214 | Rehab Medical, Inc | Durable Medical Equipment & Medical Supplies | 8568 Highway 85, Jonesboro, GA 30238 | 2017-06-07 |
| 1821472077 | Surgivue First Assisting | Nurse Practitioner | 5865 Sinclair Way, Jonesboro, GA 30238 | 2015-07-17 |
| 1518384106 | Visions of Life Behavioral Health Services, Incorporated | Counselor | 754 Chapman Street, Jonesboro, GA 30238 | 2014-03-21 |
| 1942560206 | Terri L Lee | Counselor | 7899 Waterwheel Way, Jonesboro, GA 30238 | 2012-05-21 |
| 1265704985 | Visiting Homecare Support Services, Inc. | Home Health | 10886 Tara Village Way, Jonesboro, GA 30238 | 2012-01-27 |
| 1518297175 | Heavenly Assisted Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10555 Aspenwood Ct, Jonesboro, GA 30238 | 2010-01-05 |
| 1649419821 | Carmen Melton Douglas | Speech-Language Pathologist | 10354 Shepperton Court, Jonesboro, GA 30238 | 2009-02-12 |
| 1205050259 | Caryn Ann Grzesiakowski | Chiropractor | 809 Flint River Road, Suite #4, Jonesboro, GA 30238 | 2007-04-12 |
| 1548325483 | Janet Musser Granski | Social Worker | 110 North Bend Court, Jonesboro, GA 30238 | 2006-12-22 |
| Find all providers in zip 30238 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497363436 | Just Like You Post-mastectomy Fitting Boutique | Durable Medical Equipment & Medical Supplies | 2913 King St Ste 3, Jonesboro, AR 72401-5353 | 2020-07-15 |
| 1700334455 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 110 Southwest Drive, Jonesboro, AR 72401-5827 | 2016-09-12 |
| 1972907582 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2811 Creek Dr, Jonesboro, AR 72401-5377 | 2014-10-13 |
| 1962806620 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3319 Harrisburg Rd, Jonesboro, AR 72404-8782 | 2014-10-09 |
| 1801215264 | Willie Murray | Durable Medical Equipment & Medical Supplies | 709 Belle Grove Dr, Jonesboro, GA 30238-4167 | 2014-04-14 |
| 1366879603 | Prestige Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 2224 Conrad Dr Ste A, Jonesboro, AR 72401-7222 | 2013-10-01 |
| 1790125938 | Marshall World Empire Coach/n.e.t. | Durable Medical Equipment & Medical Supplies | 7737 Jonesboro Rd, Jonesboro, GA 30236-2418 | 2013-07-02 |
| 1477893949 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 2405 S Caraway Rd, Jonesboro, AR 72401-6208 | 2013-02-21 |
| 1386912020 | Amrod, Inc. | Durable Medical Equipment & Medical Supplies | 9456 S Main St, Suite D-2, Jonesboro, GA 30236-6072 | 2011-12-08 |
| 1346545662 | Lavorne Blyden-green | Durable Medical Equipment & Medical Supplies | 7733 Town Ct, Jonesboro, GA 30236-2395 | 2011-01-18 |
| Find all providers in JONESBORO | ||||
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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.