Southwest Georgia Compounding Pharmacy

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

009638 Issued in GA

Legal business name

SOUTHWEST GEORGIA COMPOUNDING PHARMACY

Practice address

181 E Broad St
Camilla, GA 31730-1966

Phone

(229) 336-9334

Fax

(229) 336-9525

NPI assigned

Mar 22, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Joe Harris Morgan Jr.

Title

Ceo

Phone

(229) 336-9334

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1982928834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 E BROAD ST",
            "address_2": "P.O. BOX 66",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301966",
            "telephone_number": "229-336-9334",
            "fax_number": "229-336-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 E BROAD ST",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301966",
            "telephone_number": "229-336-9334",
            "fax_number": "229-336-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GEORGIA COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-22",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JOE HARRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-336-9334",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "GA",
            "license": "009638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY STATE LISCENSE NUMBER",
            "identifier": "009638",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Compounding Pharmacy in Camilla, GA
• Providers in Camilla, GA by specialty
• Compounding Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.