Organization
GATEWAY BEHAVIORAL HEALTH SERVICES
Active
Other names
GATEWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES EDWIN SMITH JR. R.PH. (PHARMACY MANAGER)
(912) 554-8469
Entity
Organization
Contact information
Practice address
600 COASTAL VILLAGE DRIVE, ROOM 107, BRUNSWICK, GA 31520
(912) 554-8467
(912) 280-1536
Mailing address
600 COASTAL VILLAGE DRIVE, ROOM 107, BRUNSWICK, GA 31520
(912) 554-8467
(912) 280-1536
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE004593
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00176756A
—
GA
Enumeration date
10/04/2006
Last updated
04/21/2011
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