Active NPI
Colleen Sacco
- Pharmacist
- Statesboro, GA
National Provider Identifier
1295128494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH027481
- Practice address
- 147 Northside Dr E
Statesboro, GA 30458-4760 - Phone
- (912) 764-2110
- NPI assigned
- Mar 11, 2015
- Last updated
- Nov 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH027481 | GA | Primary |
Addresses
Primary practice location
147 Northside Dr E
Statesboro, GA 30458-4760
Mailing address
147 Northside Dr E
Statesboro, GA 30458-4760
Other practice location 1
400 S Liberty St
Waynesboro, GA 30830-1501
Phone (706) 437-7977
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH027481 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604188800000",
"number": "1295128494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 NORTHSIDE DR E",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304584760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 NORTHSIDE DR E",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304584760",
"telephone_number": "912-764-2110"
}
],
"practiceLocations": [
{
"address_1": "400 S Liberty St",
"address_purpose": "LOCATION",
"city": "Waynesboro",
"state": "GA",
"postal_code": "308301501",
"country_code": "US",
"telephone_number": "706-437-7977",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SACCO",
"first_name": "COLLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-11",
"last_updated": "2020-11-01",
"certification_date": "2020-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH027481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.