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MIDDLE MOODYCARE INC NPI 1801881545


NPI Information

NPI: 1801881545
Provider Name: MIDDLE MOODYCARE INC

Doing Business As: POWELL'S BLOOMFIELD PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D2233534

Address:
4839 BLOOMFIELD RD
MACON, GA
ZIP 31206
Phone: (478) 781-1213
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MIDDLE MOODYCARE INC is a community/retail pharmacy pharmacy in Macon, GA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); 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. MIDDLE MOODYCARE INC NPI is 1801881545. The provider is registered as an organization entity type.
The provider Is Doing Business As Powell's Bloomfield Pharmacy.

The provider's business location address is:

4839 BLOOMFIELD RD
MACON, GA
ZIP 31206-307
Phone: (478) 781-1213
Fax: (478) 788-9078

The provider's authorized official is Robert Benjamin Moody .
The authorized official title is Pharmacist and has the following contact phone number (478) 781-1213.

The CLIA number assigned to this NPI record is 11D2233534 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2005 and was last updated on 10/24/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyPHRE006040GEORGIANo
23336C0003XPharmacyCommunity/Retail PharmacyPHRE006040GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11111828OTHERNCPDP
2000033448COTHERGEORGIAMEDICAID DME
3000033448AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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