Provider Demographics
NPI:1851342984
Name:THE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:THE MEDICAL CENTER INC
Other - Org Name:PIEDMONT PHARMACY - NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-803-5501
Mailing Address - Street 1:5601 VETERANS PKWY STE 1800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-9001
Mailing Address - Country:US
Mailing Address - Phone:706-321-3700
Mailing Address - Fax:706-321-3706
Practice Address - Street 1:5601 VETERANS PKWY STE 1800
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9001
Practice Address - Country:US
Practice Address - Phone:706-321-3700
Practice Address - Fax:706-321-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0078633336C0003X, 3336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000655267AMedicaid
GA000655267AMedicaid
1143940OtherNABP