Northeast Georgia Medical Center Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

NORTHEAST GEORGIA MEDICAL CENTER INC

Practice address

743 Spring St NE Ste 735B
Gainesville, GA 30501-3715

Phone

(770) 219-2265

NPI assigned

Mar 16, 2022

Organization subpart

Yes

Parent organization

NORTHEAST GEORGIA MEDICAL CENTER INCAs reported in NPPES

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

Authorized official

Name

Ms. Yavonda Haynes

Title

PFS Manager

Phone

(770) 219-5944

Specialties & licenses 1

Addresses

Part of

Northeast Georgia Medical Center Inc

Locations

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1124776349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741891",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE STE 735B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST GEORGIA MEDICAL CENTER INC",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "YAVONDA",
        "authorized_official_title_or_position": "PFS MANAGER",
        "authorized_official_telephone_number": "770-219-5944",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Georgia Diagnostic Associates and Clinic, LLC
• Northeast Georgia Diagnostic Clinic LLC
• Northeast Georgia Gynecology
• Northeast Georgia Health Services
• Northeast Georgia Heart Center
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.

• Community/Retail Pharmacy in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.