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PULASKI STATE PRISON REGIONAL PHARMACY
NPI 1902397995
Pharmacy - Institutional Pharmacy in Hawkinsville, GA

Active since May 24, 2018CLIA 11D2261983 · Waiver
373 UPPER RIVER RD, HAWKINSVILLE, GA 31036(478) 783-6097(478) 783-6252 Get Directions Write a Review

NPPES record last updated: May 24, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pulaski State Prison Regional Pharmacy NPPES

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

PULASKI STATE PRISON REGIONAL PHARMACY (NPI 1902397995) is a healthcare organization registered as an institutional pharmacy in Hawkinsville, Georgia and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through June 7, 2028 and lists Randy Goodroe, Pharmacy Director, as its authorized official.

NPPES Registry Identity

NPI1902397995
Entity TypeOrganization
Primary Taxonomy3336I0012X
Legal Business NamePULASKI STATE PRISON REGIONAL PHARMACY
Location Address373 UPPER RIVER RDHawkinsville, GA 31036-8898
Mailing Address373 Upper River RdHawkinsville, GA 31036-8898 · (478) 783-6097 · Fax (478) 783-6252
Phone(478) 783-6097
Fax(478) 783-6252
Organization SubpartYesParent: Georgia Department Of Corrections
Authorized OfficialRandy GoodroePharmacy Director · (478) 783-6097
Enumeration DateMay 24, 2018
✔ NPI 1902397995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Institutional PharmacySuppliers
Taxonomy Code3336I0012X
License✔ Licensed in GA · PHPR007792
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.
373 UPPER RIVER RD, Hawkinsville, GA 31036
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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 11D2261983

Pulaski State Prison · Hawkinsville, GA
Active · expires Jun 7, 2028
CLIA Number11D2261983
Laboratory TypePrison
Certificate Effective DateJune 8, 2026
Certificate Expiration DateJune 7, 2028
Laboratory DirectorMonica Hills
Laboratory Phone(678) 470-3977
Laboratory LocationPulaski State Prison373 Upper River Road, Hawkinsville, GA 31036
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 2

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

HAYLEE WARD NP-C
Nurse Practitioner (Family)
373 UPPER RIVER RD
HAWKINSVILLE, GA 31036
Pulaski County (478) 783-6000
MRS. LYNNE LAMBERTH WHCNP-BC
Nurse Practitioner (Women's Health)
373 UPPER RIVER RD
HAWKINSVILLE, GA 31036
Pulaski County (478) 783-6110

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 Pulaski State Prison Regional Pharmacy's NPI number?

The NPI number for Pulaski State Prison Regional Pharmacy is 1902397995. It was assigned to this organization in the NPPES registry on May 24, 2018.

Where is Pulaski State Prison Regional Pharmacy located?

Pulaski State Prison Regional Pharmacy is located at 373 Upper River Rd, Hawkinsville, GA 31036. The listed phone number is (478) 783-6097.

What is Pulaski State Prison Regional Pharmacy's specialty?

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

Does Pulaski State Prison Regional Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2261983) is associated with this NPI, valid through June 7, 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 Pulaski State Prison Regional Pharmacy was last updated on May 24, 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.