NPIMap

Organization Active NPI

Unison Behavioral Health Pharmacy

  • Community/Behavioral Health Agency
  • Waycross, GA
National Provider Identifier
1073568838
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
UNISON BEHAVIORAL HEALTH PHARMACY
Practice address
1007 Mary Street
Waycross, GA 31501
Phone
(912) 449-7147
Fax
(912) 449-7089
NPI assigned
May 23, 2006
Last updated
Sep 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Authorized official

Name
Mr. Henry Lynn Simpson, R.PH.
Title
Pharmacist in Charge
Phone
(912) 449-7147

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 5641 GA
Clinic Pharmacy 3336C0002X
Community/Behavioral Health Agency 251S00000X GA Primary

Addresses

Primary practice location

1007 Mary Street
Waycross, GA 31501

Mailing address

1007 Mary Street
Waycross, GA 31501
Phone (912) 449-7147

Other identifiers 3

IdentifierTypeStateIssuer
00611014AMedicaidGA
PHRE005641MedicaidGA
1115775OtherNABP

Other names 1

  • Satilla Community Services Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Pam Wheeler Host Home71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1073568838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-449-7147",
            "fax_number": "912-449-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MARY STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-449-7147",
            "fax_number": "912-449-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNISON BEHAVIORAL HEALTH PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "912-449-7147",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "GA",
            "license": "5641",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00611014A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHRE005641",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1115775",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satilla Community Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.