Okefenokee Prescription Shoppe, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

OKEFENOKEE PRESCRIPTION SHOPPE, INC.

Practice address

1710 Alice St
Waycross, GA 31501-5216

Phone

(912) 584-3796

Fax

(912) 809-2432

NPI assigned

Mar 6, 2023

Organization subpart

No

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

Authorized official

Name

Jillian Brooke Taylor, PHARMD

Title

Owner

Phone

(912) 584-3796

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1013617463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015216",
            "telephone_number": "912-584-3796",
            "fax_number": "912-809-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015216",
            "telephone_number": "912-584-3796",
            "fax_number": "912-809-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKEFENOKEE PRESCRIPTION SHOPPE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-584-3796",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Waycross, GA
• Providers in Waycross, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.