# FCI JESUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FEDERAL BUREAU OF PRISONS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508538679
- **Legal business name:** FEDERAL BUREAU OF PRISONS
- **Authorized official:** DR. PATRICK TULLY (CHIEF PHARMACIST)
- **Authorized official phone:** (912) 427-0870

## Contact information

- **Practice address:** 2600 HIGHWAY 301 SOUTH, JESUP, GA 31599-0001
- **Practice address phone:** (912) 427-0870
- **Mailing address:** 2600 HIGHWAY 301 SOUTH, JESUP, GA 31599-0001
- **Mailing address phone:** (912) 427-0870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | — | NULL | Yes |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/28/2021
- **Last updated:** 09/28/2021