Frederick C Gurley, RPH

Individual provider Active NPI Pharmacist · Jefferson, GA

NPI 1467590646 · NPPES record last updated Sep 6, 2025

Key facts

NPI
1467590646
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
13080 (GA)
Practice address
86 N Public SQ
Jefferson, GA 30549-1084
Phone
(706) 367-5252
Fax
(706) 367-2283
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13080GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford W Long Pharmacy Inc LTC Current
since Dec 29, 2024
Accepting new patients
Crawford W Long Pharmacy Inc Current Accepting new patients

Locations

86 N Public Sq
Jefferson, GA 30549
Phone (706) 367-5252

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13080 GA Yes

Addresses

Primary practice location

86 N Public SQ
Jefferson, GA 30549-1084

Mailing address

864 Storey Porter Rd
Jefferson, GA 30549-2628
Phone (706) 367-9391

Other identifiers

IdentifierTypeStateIssuer
00025495AMedicaidGA

Other names

  • Fred C Gurley Other name

Other providers in Jefferson, GA

All providers in Jefferson, GA · Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.