Fci Jesup
Organization Active NPI Prison Health Clinic/Center · Jesup, GA
NPI 1508538679 · NPPES record last updated Sep 28, 2021
Key facts
- NPI
- 1508538679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prison Health Clinic/Center 261QP2400X
- Legal business name
- FCI JESUP
- Practice address
- 2600 Highway 301 South
Jesup, GA 31599-0001 - Phone
- (912) 427-0870
- NPI assigned
- Sep 28, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- FEDERAL BUREAU OF PRISONS
Authorized official
- Name
- Dr. Patrick Tully
- Title
- Chief Pharmacist
- Phone
- (912) 427-0870
Corporate family (same tax ID) 48
Practitioners 4
-
Bolaji Aremu, PA-C
-
Shannon Bolling Ellis, D.O.
-
Nina Leah Watson, PHARMD
-
Valerie Lederer, APRN
National Provider Directory
- Tax ID family
- Federal Correctional Institution Ashland
- Part of
- Federal Correctional Institution Ashland
Locations
2600 S US Highway 301
Jesup, GA 31599
Phone (912) 427-0870
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prison Health Clinic/Center | 261QP2400X | Yes | ||
| Clinic Pharmacy | 3336C0002X |
Addresses
Primary practice location
2600 Highway 301 South
Jesup, GA 31599-0001
Mailing address
2600 Highway 301 South
Jesup, GA 31599-0001
Phone (912) 427-0870
Other providers in Jesup, GA
- Maybrie Raye Eubanks
- Hannah Brooke Evors
- F M Linder & Son LLC
- F M Linder & Son LLC
- Kelly Ashton Farrell
- Christopher John Feldman
- Kristin Lamb Fenn
- Timothy Finley
- Gary a. Lewis, D.M.D., P.a.
- Courtney Denise Gay
All providers in Jesup, GA · Prison Health Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.