Medmark Treatment Centers of Georgia, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

NTO001011 Issued in GA

Legal business name

MEDMARK TREATMENT CENTERS OF GEORGIA, INC.

Doing business as

Medmark Treatment Centers Columbus

Practice address

1301 Wynnton CT
Columbus, GA 31906-2140

Phone

(706) 576-4033

Fax

(706) 576-4230

NPI assigned

Nov 19, 2013

Organization subpart

Yes

Parent organization

MEDMARK SERVICES,INCAs reported in NPPES

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

Authorized official

Name

Bruce Jarvie

Title

VP, Treasurer

Phone

(214) 379-3300

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Medmark Treatment Centers Columbus Doing business as

Tax ID family

Medmark Treatment Centers of Georgia Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Medmark Treatment Centers of Georgia, Inc.

  dba Medmark Treatment Centers Blairsville

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Blairsville, GA
  • NPI 1316186968
  NPD tax ID
• Medmark Treatment Centers of Georgia, Inc.

  dba MedMark Treatment Centers Chatsworth

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chatsworth, GA
  • NPI 1477041143
  NPD tax ID

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1770913287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WYNNTON CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319062140",
            "telephone_number": "706-576-4033",
            "fax_number": "706-576-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDMARK TREATMENT CENTERS OF GEORGIA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDMARK SERVICES,INC",
        "enumeration_date": "2013-11-19",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "GA",
            "license": "0000000",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "GA",
            "license": "NTO001011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NARCOTIC TREATMENT PROGRAM PERMIT",
            "identifier": "NTP001011",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medmark Treatment Centers Columbus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medmark Treatment Centers Columbus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Center, Inc. (Regional Boutique)
• Medical Connections LLC
• Sidney Donette Medina
• Madonna Laree Medley
• Judith Louann Medlock, RPH
• Kenneth Andrew Medve, LCSW
• Jessica Joy Medzie
• Thalia Meeks, BCBA
• Hillary B. Mehas, LPC
• Namita Mehta, MD

• Substance Use Disorder Rehabilitation Clinic/Center in Columbus, GA
• Providers in Columbus, GA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.