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AUTRY STATE PRISON PHARMACY
NPI 1831689728
Pharmacy - Institutional Pharmacy in Pelham, GA

Active since May 16, 2018CLIA 11D2263192 · Waiver
3178 MOUNT ZION CHURCH RD, PELHAM, GA 31779(229) 294-6786(229) 294-6788 Get Directions Write a Review

NPPES record last updated: May 23, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 23, 2018, May 16, 2018 (2 updates tracked since 2018).

About Autry State Prison Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUTRY STATE PRISON PHARMACY (NPI 1831689728) is a healthcare organization registered as an institutional pharmacy in Pelham, Georgia and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through June 23, 2028 and lists Deena Jones Gainous, Pharmacy Director, as its authorized official.

NPPES Registry Identity

NPI1831689728
Entity TypeOrganization
Primary Taxonomy3336I0012X
Legal Business NameAUTRY STATE PRISON PHARMACY
Location Address3178 MOUNT ZION CHURCH RDPelham, GA 31779
Mailing AddressPo Box 648Pelham, GA 31779-0648 · (229) 294-6786 · Fax (229) 294-6788
Phone(229) 294-6786
Fax(229) 294-6788
Organization SubpartYesParent: Georgia Department Of Corrections
Authorized OfficialDeena Jones GainousPharmacy Director · (229) 294-6786
Enumeration DateMay 16, 2018
Last NPPES UpdateMay 23, 20182 updates tracked since enumeration
✔ NPI 1831689728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Institutional PharmacySuppliers
Taxonomy Code3336I0012X
License✔ Licensed in GA · PHPR007470
Definition
A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; 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.
3178 MOUNT ZION CHURCH RD, Pelham, GA 31779
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2263192

Autry State Prison · Pelham, GA
Active · expires Jun 23, 2028
CLIA Number11D2263192
Laboratory TypePrison
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorMark Wood
Laboratory Phone(678) 470-3977
Laboratory LocationAutry State Prison3178 Mount Zion Church Road, Pelham, GA 31779
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LISA TAYLOR SPEIGNER NP
Nurse Practitioner (Family)
3178 MOUNT ZION CHURCH RD
PELHAM, GA 31779
Mitchell County (229) 294-2940

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Autry State Prison Pharmacy's NPI number?

The NPI number for Autry State Prison Pharmacy is 1831689728. It was assigned to this organization in the NPPES registry on May 16, 2018.

Where is Autry State Prison Pharmacy located?

Autry State Prison Pharmacy is located at 3178 Mount Zion Church Rd, Pelham, GA 31779. The listed phone number is (229) 294-6786.

What is Autry State Prison Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Institutional Pharmacy, with taxonomy code 3336I0012X.

Does Autry State Prison Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2263192) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Autry State Prison Pharmacy was last updated on May 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.