AUGUSTA STATE MEDICAL PRISON (NPI# 1902397151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902397151 |
| Entity Type | Organization |
| Organization Name | AUGUSTA STATE MEDICAL PRISON |
| Practice Address |
3001 Gordon Hwy Grovetown GA 30813-3808 |
| Practice Telephone | 7068554744 |
| Practice Fax Number | 7068697990 |
| Mailing Telephone | 7068554744 |
| Mailing Fax Number | 7068697990 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | DR. ELAINE REIFINGER (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 7068554789 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA DEPARTMENT OF CORRECTIONS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
PHH006083 | GA | Suppliers |
| Street Address |
3001 GORDON HWY |
| City | GROVETOWN |
| State | GA |
| Zip Code | 30813-3808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477674497 | Judieth Evonne Baker-brown | Internal Medicine | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2007-04-03 |
| 1982211520 | Elijah Lee Carter | Rehabilitation Counselor | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2020-09-28 |
| 1598144065 | William Cheatam | Physician Assistant | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2015-05-29 |
| 1578942769 | Georgia Dept. of Corrections | General Acute Care Hospital | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2015-05-21 |
| 1558740704 | Colette Vincent | Nurse Practitioner | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2015-05-20 |
| 1336383751 | Tiffany Nicole Parks | Internal Medicine | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2009-04-29 |
| 1235340852 | Cynthia S Ditslear | Dentist | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2007-05-25 |
| 1366653313 | Millie Reeves | Physician Assistant | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2007-05-24 |
| 1073724894 | Smitha Suraj | Internal Medicine | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2007-05-24 |
| 1427261130 | Timothy Young | General Practice | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2007-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276412 | Georgia Dental Professionals, PC | Dentist | 9596 Bentley Dr., Grovetown, GA 30813 | 2017-10-18 |
| 1558891895 | Jennifer M Humm | Dentist | 250 Merridian Drive, Grovetown, GA 30813 | 2017-06-19 |
| 1710335443 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 435 Lewiston Rd, Grovetown, GA 30813 | 2016-06-03 |
| 1558727214 | Lynda R Green | Counselor | 426 Northrop Place, Grovetown, GA 30813 | 2016-01-11 |
| 1689002610 | Patriots Park Dental, LLC | Dentist | 701 Devika Drive, Ste 10, Grovetown, GA 30813 | 2013-10-30 |
| 1255680096 | David Schulte Jr. | Internal Medicine | 925 Branch Ct Ste 2101, Grovetown, GA 30813 | 2012-09-07 |
| 1548519481 | Ashley Roberts Saunders | Pharmacist | 869 Horizon South Parkway, Grovetown, GA 30813 | 2012-09-06 |
| 1447569694 | Wallace Allen Partridge Jr. | Pharmacist | 5104 Wrightsboro Rd., Fred's Pharmacy 1699, Grovetown, GA 30813 | 2010-10-05 |
| 1497908149 | Sharon M Blair | Registered Nurse | 7640 Pleasantville Way, Grovetown, GA 30813 | 2008-10-28 |
| 1710160791 | Rebecca Meek | Nurse Practitioner | 469 Lewiston Rd, Grovetown, GA 30813 | 2007-12-12 |
| Find all providers in zip 30813 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on AUGUSTA STATE MEDICAL PRISON.
| 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.