Gowyn Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009915 Issued in GA

Legal business name

GOWYN INC

Doing business as

Open Gate Pharmacy 1

Practice address

2051 10TH Ave
Columbus, GA 31901-1459

Phone

(706) 323-0306

Fax

(706) 327-3824

NPI assigned

Jun 11, 2007

Organization subpart

No

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

Authorized official

Name

Mojisola Evbuomwan, PHARMD

Title

Owner

Phone

(706) 323-0306

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• OPEN GATE PHARMACY 1 Doing business as

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1740484179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 10TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011459",
            "telephone_number": "706-323-0306",
            "fax_number": "706-327-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 10TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011459",
            "telephone_number": "706-323-0306",
            "fax_number": "706-327-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOWYN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "EVBUOMWAN",
        "authorized_official_first_name": "MOJISOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-323-0306",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009915",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140755",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00479806A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPEN GATE PHARMACY 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Columbus, GA
• Providers in Columbus, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.