NPIMap

Organization Active NPI

Hospital Authority of Valdosta & Lowndes County, Ga

  • Psychiatric Pharmacist
  • Valdosta, GA
National Provider Identifier
1629101779
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric PharmacistTaxonomy code 1835P1300X
License
PHH006327 Issued in GA
Legal business name
HOSPITAL AUTHORITY OF VALDOSTA & LOWNDES COUNTY, GA
Practice address
2501 N Patterson St
Valdosta, GA 31602-1735
Phone
(229) 259-4938
Fax
(229) 259-4925
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael Lane
Title
Administrator
Phone
(229) 671-6601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1835P1300X PHH006327 GA Primary

Addresses

Primary practice location

2501 N Patterson St
Valdosta, GA 31602-1735

Mailing address

2209 Pineview Dr
Valdosta, GA 31602-7316
Phone (229) 671-6675

Other names 1

  • Greenleaf Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southe Georgia Medical13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2209 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

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": "1598054400000",
    "number": "1629101779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 PINEVIEW DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316027316",
            "telephone_number": "229-671-6675",
            "fax_number": "229-245-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-259-4938",
            "fax_number": "229-259-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF VALDOSTA & LOWNDES COUNTY, GA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-671-6601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist, Psychiatric",
            "state": "GA",
            "license": "PHH006327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenleaf Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

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