Ty Cobb Healthcare System Long Term Care Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHRE005718 Issued in GA

Legal business name

TY COBB HEALTHCARE SYSTEM LONG TERM CARE PHARMACY

Doing business as

Ty Cobb LTC Pharmacy

Practice address

521 Franklin Springs St
Royston, GA 30662-3934

Phone

(706) 245-1467

Fax

(706) 245-1421

NPI assigned

Dec 6, 2005

Last updated

Jan 25, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica McDonald, PHARM.D.

Title

Director

Phone

(706) 245-1271

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• TY COBB LTC PHARMACY Doing business as

Tax ID family

Healthworks - Cobb Memorial Hospital2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ty Cobb Healthcare System, Inc.

  dba HealthWorks - Cobb Memorial Hospital

  • Occupational Medicine Physician
  • Lavonia, GA
  • NPI 1962771287
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1023092624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 FRANKLIN SPRINGS ST",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "306623934",
            "telephone_number": "706-245-1467",
            "fax_number": "706-245-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 FRANKLIN SPRINGS ST",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "306623934",
            "telephone_number": "706-245-1467",
            "fax_number": "706-245-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TY COBB HEALTHCARE SYSTEM LONG TERM CARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "706-245-1271",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE005718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1126095",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00059562B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TY COBB LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Turner Podiatry and Wound Care LLC
• Kristen Harris Turner
• Ty Cobb Healthcare System (Cobb Memorial Hospital)
• Ty Cobb Healthcare System (Brown Memorial Convalescent Center)
• Ty Cobb Healthcare System (Cobb Memorial Hospital Swingbed Unit)
• Ty Cobb Medical Group
• Veralynn Anesthesia Associates of Georgia, LLC
• Veralynn Health Management, LLC
• Village Podiatry Group II, LLC. (Village Podiatry Centers)
• Village Podiatry Group, LLC (Village Podiatry Centers)

• Long Term Care Pharmacy in Royston, GA
• Providers in Royston, GA by specialty
• Long Term Care Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.