NPIMap

Organization Active NPI

Wayne Memorial Hospital Pharmacy Retail

  • General Acute Care Hospital
  • Jesup, GA
National Provider Identifier
1649650656
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
PHRE010123 Issued in GA
Legal business name
WAYNE MEMORIAL HOSPITAL PHARMACY RETAIL
Practice address
865 S 1St St
Jesup, GA 31545-0210
Phone
(912) 530-3367
Fax
(912) 530-3370
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Dr. Elizabeth Hendrix Gorse, PHARMD
Title
Director of Pharmacy
Phone
(912) 530-3367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X PHRE010123 GA Primary

Addresses

Primary practice location

865 S 1St St
Jesup, GA 31545-0210

Mailing address

865 S 1St St
Jesup, GA 31545-0210
Phone (912) 530-3367

National Provider Directory

National Provider Directory
Tax ID family
Wayne Co Ambulance Co7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1649650656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 S 1ST ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450210",
            "telephone_number": "912-530-3367",
            "fax_number": "912-530-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 S 1ST ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450210",
            "telephone_number": "912-530-3367",
            "fax_number": "912-530-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE MEMORIAL HOSPITAL PHARMACY RETAIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "GORSE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "HENDRIX",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "912-530-3367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "PHRE010123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.