Skidaway Village Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHRE008485 Issued in GA

Legal business name

SKIDAWAY VILLAGE PHARMACY INC

Practice address

1 Skidaway Village Walk
Savannah, GA 31411-2908

Phone

(912) 598-8669

Fax

(912) 598-7208

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jason Paul Conley, PHARMDNPI 1356417885

Title

Pharmacist

Phone

(912) 598-8669

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• VILLAGE WALK PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason P Conley, PHARMD

  • Pharmacist
  • Savannah, GA
  • NPI 1356417885
  NPD Authorized official
• Susanne S Conley, PHARMD

  • Pharmacist
  • Savannah, GA
  • NPI 1093850521
  NPD (past)
• Wesley Jordan Turner, PHARMD

  • Pharmacist
  • Savannah, GA
  • NPI 1306449996
  NPD (past)
• Ashlie N Woods, PHARMD

  • Pharmacist
  • Augusta, GA
  • NPI 1740582220
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1710022207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SKIDAWAY VILLAGE WALK",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314112908",
            "telephone_number": "912-598-8669",
            "fax_number": "912-598-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SKIDAWAY VILLAGE WALK",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314112908",
            "telephone_number": "912-598-8669",
            "fax_number": "912-598-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIDAWAY VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "912-598-8669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE008485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000895485A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1133533",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHRE008485",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VILLAGE WALK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Skidaway Behavioral Institute LLC
• Skidaway Health and Living Services, Inc.
• Skidaway Medical Group LLC
• Skidaway Medical Group LLC
• Skidaway Village Pharmacy Inc
• Holland Skidmore
• Sarah Byrd Skinner, MD
• Stephanie L Skinner, D.M.D.
• William Colby Skinner, MD
• Veronica Slater

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.