NPIMap

Organization Active NPI

South Georgia Medical Center

  • Pharmacy
  • Valdosta, GA
National Provider Identifier
1831171867
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHRE006396 Issued in GA
Legal business name
SOUTH GEORGIA MEDICAL CENTER
Practice address
2501 North Patterson Street
Valdosta, GA 31603-1727
Phone
(229) 259-4869
Fax
(229) 259-4872
NPI assigned
Nov 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. William M. Brannen, R.PH.
Title
Director of Pharmacy
Phone
(229) 259-4869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHRE006396 GA Primary

Addresses

Primary practice location

2501 North Patterson Street
Valdosta, GA 31603-1727

Mailing address

2501 North Patterson Street
Valdosta, GA 31603-1727
Phone (229) 259-4869

Other identifiers 1

IdentifierTypeStateIssuer
PHRE006396OtherGAPHARMACY LICENSE #

National Provider Directory

National Provider Directory
Tax ID family
Southe Georgia Medical13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1831171867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 NORTH PATTERSON STREET",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316031727",
            "telephone_number": "229-259-4869",
            "fax_number": "229-259-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 NORTH PATTERSON STREET",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316031727",
            "telephone_number": "229-259-4869",
            "fax_number": "229-259-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BRANNEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "229-259-4869",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE006396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE #",
            "identifier": "PHRE006396",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.