Mayo Clinic Health System in Waycross, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS, INC.

Doing business as

Institutional Pharmacy

Practice address

2007 Tebeau St
Waycross, GA 31501-6358

Phone

(912) 285-9164

NPI assigned

Jul 13, 2005

Last updated

Sep 5, 2012By 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

Mr. Chris Carbaugh, BSPH, R.PH.

Title

Operations Manager

Phone

(912) 285-9164

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Institutional Pharmacy Doing business as

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1629076526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016358",
            "telephone_number": "912-285-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016358",
            "telephone_number": "912-285-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM IN WAYCROSS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "CARBAUGH",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "912-285-9164",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSPH, R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001229C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Institutional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mayo Clinic Health System in Waycross, Inc
• Mayo Clinic Health System in Waycross, Inc. (Satilla Care Center)
• Mayo Clinic Health System in Waycross, Inc.
• Mayo Clinic Health System in Waycross, Inc.
• Mayo Clinic Health System in Waycross, Inc.
• Joshua Wade McCarthy, MD
• Randall W McCarthy, P.A.
• Christopher Jason McCellan, RN
• Eugene Carter McDonald III, PHARM.D
• Lindey Danielle McGahee-Washington

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.