Medical Center Pharmacy of Statesboro, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE006387 Issued in GA

Legal business name

MEDICAL CENTER PHARMACY OF STATESBORO, INC

Doing business as

Medical Center Pharmacy

Practice address

57 Granade St
Statesboro, GA 30458

Phone

(912) 764-5643

Fax

(912) 764-9580

NPI assigned

Feb 25, 2007

Organization subpart

Yes

Parent organization

MEDICAL CENTER PHARMACY OF STATESBORO, INCAs reported in NPPES

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

Authorized official

Name

Mr. James Lemuel Nevil III, RPH

Title

Pharmacist/Owner

Phone

(912) 764-5643

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medical Center Pharmacy Doing business as

Part of

Medical Center Pharmacy of Statesboro Inc

Locations

Practitioners 2

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

• Lisa Finch Laircey, PHARMD

  • Pharmacist
  • Statesboro, GA
  • NPI 1902015241
  NPD (past)
• Joe W Pennington, R.PH.

  • Pharmacist
  • Statesboro, GA
  • NPI 1568450260
  NPD (past)

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1922134089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 GRANADE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-764-5643",
            "fax_number": "912-764-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GRANADE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-764-5643",
            "fax_number": "912-764-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PHARMACY OF STATESBORO, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL CENTER PHARMACY OF STATESBORO, INC",
        "enumeration_date": "2007-02-25",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "NEVIL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LEMUEL",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "912-764-5643",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE006387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00031842A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Me Pivot Holdings LLC (Miracle-Ear Center)
• Me Pivot Holdings, LLC
• Meadows DME, LLC
• Meadows Healthcare Alliance, Inc. (Alliance Home Medical)
• Michelle Meadows, LPC, CPRP
• Medical Diagnostics of Statesboro LLC
• Medical Health Group LLC
• Merian Mendoza, OTR/L
• Kathryn Ward Mentzer, D.M.D.
• Dalysette Merced Reyes, PHARMD

• Community/Retail Pharmacy in Statesboro, GA
• Providers in Statesboro, 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 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.