NPIMap

Organization Active NPI

Northeast Georgia Medical Center, Inc.

  • Community/Retail Pharmacy
  • Gainesville, GA
National Provider Identifier
1164042867
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NORTHEAST GEORGIA MEDICAL CENTER, INC.
Practice address
1439 Jesse Jewell Pkwy NE
Gainesville, GA 30501-3806
Phone
(770) 219-6337
NPI assigned
Apr 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Brian D Steines
Title
Cfo
Phone
(770) 219-3562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1439 Jesse Jewell Pkwy NE
Gainesville, GA 30501-3806

Mailing address

PO Box 741891
Atlanta, GA 30374-1891
Phone (770) 219-6337

Other names 1

  • Northeast Georgia Medical Center EE Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ga Med Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1164042867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741891",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741891",
            "telephone_number": "770-219-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 JESSE JEWELL PKWY NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "770-219-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "STEINES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-219-3562"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Georgia Medical Center EE Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.