NPIMap

Organization Active NPI

Maddens Pharmacy Inc

  • Community/Retail Pharmacy
  • Elberton, GA
National Provider Identifier
1992720221
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE006766 Issued in GA
Legal business name
MADDENS PHARMACY INC
Doing business as
Madden's Pharmacy, Inc.
Practice address
101 College Ave
Elberton, GA 30635-1705
Phone
(706) 283-1701
Fax
(706) 283-1704
NPI assigned
Jul 13, 2006
Last updated
Dec 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Authorized official

Name
Donald Joseph Piela Jr.NPI 1255568952
Title
President/Pharmacist in Charge
Phone
(706) 283-1701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Oxygen Equipment & Supplies (DME) 332BX2000X
Community/Retail Pharmacy 3336C0003X PHRE006766 GA Primary
Long Term Care Pharmacy 3336L0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

101 College Ave
Elberton, GA 30635-1705

Mailing address

101 College Ave
Elberton, GA 30635-1705
Phone (706) 283-1701

Other identifiers 4

IdentifierTypeStateIssuer
2012351OtherPK
000031193AMedicaidGA
000650273AMedicaidGA
000031193BMedicaidGA

Other names 1

  • Madden's Pharmacy, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930072511 GA DME Supplier - PharmacyDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply Company With Registered Pharmacist 3375580269 Practice locations: Elberton, GA
O20130711000803 GA Part B Supplier - Mass Immunization (Roster Biller Only) 3375580269 Practice locations: Elberton, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0984975Madden Pharmacy, Inc101 College Ave, Elberton, GA 30635Certificate of waiverJan 25, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Madden's Pharmacy, Inc.101 College Ave, Elberton, GA 30635-1705(706) 283-1701 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Hospital Beds (Electric)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Patient Lifts|Seat Lift Mechanisms|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Or… Accepts assignmentParticipating since Feb 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Madden's Pharmacy Inc2 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.

Locations

101 College Ave
Elberton, GA 30635
Phone (706) 283-1701

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1992720221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 COLLEGE AVE",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306351705",
            "telephone_number": "706-283-1701",
            "fax_number": "706-283-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COLLEGE AVE",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306351705",
            "telephone_number": "706-283-1701",
            "fax_number": "706-283-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADDENS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "PIELA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "706-283-1701",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE006766",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012351",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000031193A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000650273A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000031193B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madden's Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Madden's Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elberton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.