NPIMap

Organization Active NPI

Northeast Georgia Health Services

  • Managed Care Organization Pharmacy
  • Gainesville, GA
National Provider Identifier
1518090836
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
PHRE007738 Issued in GA
Legal business name
NORTHEAST GEORGIA HEALTH SERVICES
Practice address
825 Jesse Jewell Parkway Suite D
Gainesville, GA 30501-3715
Phone
(678) 897-6337
Fax
(678) 897-6338
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Brian D Steines
Title
Cfo
Phone
(770) 219-3562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Managed Care Organization Pharmacy 3336M0003X PHRE007738 GA Primary

Addresses

Primary practice location

825 Jesse Jewell Parkway Suite D
Gainesville, GA 30501-3715

Mailing address

PO Box 741891
Atlanta, GA 30374-1891
Phone (770) 531-3800

Other names 1

  • EMPLOYEE PHARMACY Other name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ga Med Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1518090836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741891",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741891",
            "telephone_number": "770-531-3800",
            "fax_number": "770-538-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 JESSE JEWELL PARKWAY SUITE D",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "678-897-6337",
            "fax_number": "678-897-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "STEINES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-219-3562"
    },
    "taxonomies": [
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "GA",
            "license": "PHRE007738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMPLOYEE PHARMACY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "EMPLOYEE PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.