Individual provider Active NPI

Eric Ray Bracewell, PHARMD

  • Pharmacist
  • Brunswick, GA
National Provider Identifier
1922608397
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH031705 Issued in GA
Practice address
10100 Canal Xing
Brunswick, GA 31525-6705
Phone
(912) 602-6809
Fax
(912) 602-6808
NPI assigned
Oct 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH031705 GA Primary

Addresses

Primary practice location

10100 Canal Xing
Brunswick, GA 31525-6705

Mailing address

287 Long Way S
Brunswick, GA 31523-7913
Phone (912) 278-2238

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH031705GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1922608397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 LONG WAY S",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315237913",
            "telephone_number": "912-278-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 CANAL XING",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256705",
            "telephone_number": "912-602-6809",
            "fax_number": "912-602-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEWELL",
        "first_name": "ERIC",
        "middle_name": "RAY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH031705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.