Phillips Drugs, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHRE003663 Issued in GA

Legal business name

PHILLIPS DRUGS, INC

Doing business as

Phillips Pharmacy

Practice address

306 W 1St St
Vidalia, GA 30474-3369

Phone

(912) 537-3049

Fax

(912) 537-3040

NPI assigned

Dec 26, 2006

Last updated

Jan 9, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Heather Hall Gourley, R.PH.NPI 1710196597

Title

Pharmacist

Phone

(912) 537-3049

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Phillips Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Hall Gourley, R.PH

  • Pharmacist
  • Vidalia, GA
  • NPI 1710196597
  NPD (past) Authorized official
• Angela Combs, RPH

  • Pharmacist
  • Vidalia, GA
  • NPI 1093429920
  NPD
• Paul Russell Combs, R.PH.

  • Pharmacist
  • Vidalia, GA
  • NPI 1770648354
  NPD
• Virginia Grace Gourley Cato, PHARMD, RPH

  • Pharmacist
  • Vidalia, GA
  • NPI 1548976061
  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1437214012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750120",
            "telephone_number": "912-537-3049",
            "fax_number": "912-537-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W 1ST ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304743369",
            "telephone_number": "912-537-3049",
            "fax_number": "912-537-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS DRUGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "HALL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "912-537-3049",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE003663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1115369",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00033228A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phillips Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara T Peacock, FNP
• Brendan Darby Pearsall, PHARMD
• John Peery, RPH
• Peterson Dermatology, P.C.
• Letty Revell Peterson, M.D.
• Phillips Drugs, Inc (Phillips Pharmacy (LTC))
• Amanda Shea Phillips, FNP
• Andrea Phillips
• Annilyne Michele Phillips, RPH
• Kimberly Nichole Phillips, FNP-C

• Pharmacy in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.