NPIMap

Organization Active NPI

J C Lewis Primary Health Care Center

  • Pharmacy
  • Savannah, GA
National Provider Identifier
1508453994
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
J C LEWIS PRIMARY HEALTH CARE CENTER
Practice address
5 Mall Anx
Savannah, GA 31406-4738
Phone
(912) 721-6735
NPI assigned
Dec 31, 2020
Last updated
Nov 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
J C LEWIS PRIMARY HEALTH CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Mr. Hilton Fordham
Title
HR Director
Phone
(912) 721-6706

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

5 Mall Anx
Savannah, GA 31406-4738

Mailing address

PO Box 13577
Savannah, GA 31416-0577
Phone (912) 495-8887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220418001761 GA Part B Supplier - Pharmacy 8426203225 Practice locations: Savannah, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
JC Lewis Primary Healthcar6 organizations share this tax ID, including this one
Part of
JC Lewis Primary Healthcar

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

125 Fahm St
Savannah, GA 31401
Phone (912) 495-8887

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
J.C. Lewis Primary Healthcare Center, IncSavannah, GA, CCN 111957 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2011
J.C. Lewis Primary Healthcare Center, IncSavannah, GA, CCN 111978 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2011
J.C. Lewis Primary Healthcare Center, IncSavannah, GA, CCN 111065 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1508453994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13577",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314160577",
            "telephone_number": "912-495-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MALL ANX",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064738",
            "telephone_number": "912-721-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J C LEWIS PRIMARY HEALTH CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J C LEWIS PRIMARY HEALTH CARE CENTER",
        "enumeration_date": "2020-12-31",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "FORDHAM",
        "authorized_official_first_name": "HILTON",
        "authorized_official_title_or_position": "HR DIRECTOR",
        "authorized_official_telephone_number": "912-721-6706",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.