Active NPI
Sergey Bagan, PHARM D
- Pharmacist
- Brunswick, GA
National Provider Identifier
1689188930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH030310
- Practice address
- 3487 Cypress Mill Rd
Brunswick, GA 31520-2857 - Phone
- (912) 265-6330
- NPI assigned
- Nov 24, 2017
- Last updated
- Nov 24, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH030310 | GA | Primary |
Addresses
Primary practice location
3487 Cypress Mill Rd
Brunswick, GA 31520-2857
Mailing address
1258 Sunset Blvd Apt 4E
Jesup, GA 31545-7803
Phone (570) 706-6852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH030310 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511481600000",
"number": "1689188930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1258 SUNSET BLVD APT 4E",
"city": "JESUP",
"state": "GA",
"postal_code": "315457803",
"telephone_number": "570-706-6852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3487 CYPRESS MILL RD",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315202857",
"telephone_number": "912-265-6330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGAN",
"first_name": "SERGEY",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-24",
"last_updated": "2017-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH030310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.