NPIMap

Organization Active NPI

Hospital Authority of Jeff Davis County Georgia

  • Community/Retail Pharmacy
  • Hazlehurst, GA
National Provider Identifier
1194394239
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HOSPITAL AUTHORITY OF JEFF DAVIS COUNTY GEORGIA
Practice address
163 S Tallahassee St
Hazlehurst, GA 31539-6465
Phone
(912) 375-7781
Fax
(912) 375-4881
NPI assigned
Jun 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Barry Bloom
Title
Ceo
Phone
(912) 375-7781

Specialties & licenses 1

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

Addresses

Primary practice location

163 S Tallahassee St
Hazlehurst, GA 31539-6465

Mailing address

163 S Tallahassee St
Hazlehurst, GA 31539-6465
Phone (912) 375-7781

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdhpharmacy@jeffdavishospital.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Hospital Auth of Jeff D7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1194394239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396465",
            "telephone_number": "912-375-7781",
            "fax_number": "912-375-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396465",
            "telephone_number": "912-375-7781",
            "fax_number": "912-375-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF JEFF DAVIS COUNTY GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-375-7781"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdhpharmacy@jeffdavishospital.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "163 S Tallahassee St",
            "city": "Hazlehurst",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315396465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.