NPIMap

Organization Active NPI

Gateway Behavioral Health Services

  • Pharmacy
  • Brunswick, GA
National Provider Identifier
1134214943
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHRE004593 Issued in GA
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
600 Coastal Village Drive, Room 107
Brunswick, GA 31520
Phone
(912) 554-8467
Fax
(912) 280-1536
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Mr. James Edwin Smith Jr., R.PH.
Title
Pharmacy Manager
Phone
(912) 554-8469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHRE004593 GA Primary

Addresses

Primary practice location

600 Coastal Village Drive, Room 107
Brunswick, GA 31520

Mailing address

600 Coastal Village Drive, Room 107
Brunswick, GA 31520
Phone (912) 554-8467

Other identifiers 1

IdentifierTypeStateIssuer
00176756AMedicaidGA

Other names 1

  • GATEWAY PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gateway Community Service Board72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

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

View all 23

Locations

600 Coastal Village Dr
Rm 107
Brunswick, GA 31520
Phone (912) 574-4210

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1134214943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COASTAL VILLAGE DRIVE, ROOM 107",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-554-8467",
            "fax_number": "912-280-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COASTAL VILLAGE DRIVE, ROOM 107",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-554-8467",
            "fax_number": "912-280-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "912-554-8469",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE004593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00176756A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GATEWAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.