# MACON STATE PRISON REGIONAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GEORGIA DEPARTMENT OF CORRECTIONS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316438393
- **Legal business name:** GEORGIA DEPARTMENT OF CORRECTIONS
- **Authorized official:** DR. SHAWN LAW PHARMD (PHARMACY DIRECTOR)
- **Authorized official phone:** (478) 472-3639

## Contact information

- **Practice address:** 2728 GA HIGHWAY 49 S, OGLETHORPE, GA 31068-8129
- **Practice address phone:** (478) 472-3639
- **Practice address fax:** (478) 472-3640
- **Mailing address:** PO BOX 426, OGLETHORPE, GA 31068-0426
- **Mailing address phone:** (478) 472-3639
- **Mailing address fax:** (478) 472-3640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | PHPR007682 | GA | Yes |

## Other

- **Enumeration date:** 05/24/2018
- **Last updated:** 05/24/2018