Active NPI
Heather Hall Gourley, R.PH
- Pharmacist
- Vidalia, GA
National Provider Identifier
1710196597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17964
- Practice address
- 306 W 1St St
Vidalia, GA 30474-3369 - Phone
- (912) 537-3049
- Fax
- (912) 537-3040
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 17964 | GA | Primary |
Addresses
Primary practice location
306 W 1St St
Vidalia, GA 30474-3369
Mailing address
306 W 1St St
Vidalia, GA 30474-3369
Phone (912) 537-3049
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17964 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phillips Drugs, Inc | Past | Accepting new patients | |
| Phillips Drugs, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710196597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 W 1ST ST",
"city": "VIDALIA",
"state": "GA",
"postal_code": "304743369",
"telephone_number": "912-537-3049",
"fax_number": "912-537-3040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 W 1ST ST",
"city": "VIDALIA",
"state": "GA",
"postal_code": "304743369",
"telephone_number": "912-537-3049",
"fax_number": "912-537-3040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOURLEY",
"first_name": "HEATHER",
"middle_name": "HALL",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "17964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vidalia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.