NPIMap

Organization Active NPI

West Georgia Medical Center, Inc

  • Clinic Pharmacy
  • Lagrange, GA
National Provider Identifier
1225849185
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
WEST GEORGIA MEDICAL CENTER, INC
Doing business as
Wellstar Pharmacy Network #12
Practice address
1514 Vernon Rd
Lagrange, GA 30240-4131
Phone
(470) 644-0328
NPI assigned
Jan 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Authorized official

Name
Mr. Ebenezer Erzuah
Title
Exec. Director Reimbursement
Phone
(470) 956-4981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

1514 Vernon Rd
Lagrange, GA 30240-4131

Mailing address

793 Sawyer Rd
Marietta, GA 30062-2222

Other names 1

  • Wellstar Pharmacy Network #12 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Georgia Medical Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1737158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737158400000",
    "number": "1225849185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 SAWYER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "470-644-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-18",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A",
        "authorized_official_last_name": "ERZUAH",
        "authorized_official_first_name": "EBENEZER",
        "authorized_official_title_or_position": "EXEC. DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "470-956-4981",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellstar Pharmacy Network #12",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2025; 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.